经纤维支气管镜注药联合雾化吸入治疗支气管结核的疗效观察

Study on efficacy of antituberculosis drugs administratiom by fiberobronchoscopy and aerosol inhalation in endobronchial tuberculosis

目的探讨支气管结核经全身抗结核治疗同时辅以经纤支镜注药及雾化吸入的治疗效果。方法将228例确诊为支气管结核的住院患者随机分为研究组116例和对照组112例。研究组在全身抗结核治疗同时给予定期经纤支镜注药及雾化吸入,对照组单纯给予全身抗结核治疗。分别对2组在治疗2个月末和8个月末的临床治疗效果进行比较。结果治疗2个月末和8个月末,研究组的临床症状改善、痰菌阴转率、病灶吸收好转、纤支镜下改变和对照组比较差异有统计学意义(P<0.01,P<0.05)。镜下分型研究组,肉芽增殖型、溃疡坏死型的疗效和对照组比较差异有统计学意义(P<0.01,P<0.05)。结论全身抗结核治疗同时辅以经纤维支气管镜(纤支镜)注药及雾化吸入治疗支气管结核在临床症状改善、痰菌阴转率、胸部X线片病灶吸收方面的疗效明显优于单纯的全身抗结核治疗。

Objective To determine the efficacy of systemic antituberculosis chemotherapy combined with antituberculosis drugs administration by fiberobronchoscopy and aerosol inhalation in endobronchial tuberculosis. Methods 228 patients with endobrochial tuberculosis were recuited and divided randomly into a study group with 116 cases and a control group with 112 cases.Systemic antituberculosis chemotherapy and antituberculosis drugs administration by fiberobronchoscopy and aerosol inhalation were given to the study group.The control group recieved systemic antituberculosis chemotherapy alone.The clinical outcomes after 2 months and 8 months＇ treatment between two groups were compared. Results At the end of 2 months and 8 months＇ therapy,the improvement on clinical symptoms,radiographic and bronchoscopic manifestations and sputum negative convertion rate in the study group were significant higher than those in the control group（P0.01,P0.05）.The efficacy on subtypes of granuloma and ulcer in the study group was better than that of control group（P0.01,P0.05）. Conclusions The combination of systemic antituberculosis chemotherapy with antituberculosis drugs administration by fiberobronchoscopy and aerosol inhalation is more effective than that of systemic chemotherapy alone in endobronchial tuberculosis.