纤维支气管镜介入治疗耐多药肺结核40例报道

A report of the treatment of 40 MDR-TB by fiberbronchoscope

目的探讨纤维支气管镜在C型臂或X线定位下经导管介入治疗,配合全身化疗对耐多药肺结核的治疗效果。方法将80例耐多药肺结核患者随机分为治疗组(40例)和对照组(40例),两组均采用6个月乳酸左氧氟沙星、丙硫异烟胺、力克肺疾、丁胺卡那霉素(或卷曲霉素)或者通过药敏选择个体化治疗方案。治疗组强化期每月经纤维支气管镜注药一次,共计8次。然后比较两组的治疗效果。结果治疗6个月时,痰菌阴转率、病灶显效率、空洞闭合率方面两组统计学意义(P<0.01),未发生相关的毒副反应。结论经纤维支气管镜介入给药治疗耐多药肺结核,疗效明显优于单纯全身化疗,值得在临床推广。

Objective To explore the treatment effect of MDR-TB through catheter by using fiberbronchoscope positoned by X-ray or C-arm, together with general ehemothrapy. Methods 80 cases of MDR-TB were randomly divided into two groups：treatment group （40 cases ）and control group （40 cases）, both were treated by individual therapy through 6-month Levofloxacin, protionamide, dipasic and ami- kacin,or through drug sensitive choice. The control group were injected through fiberbronehoseope 8 times every month during the enhancing period. Then the treatment results of the two groups were compared. Results After 6 months of treatment, no side effects were showed in the statistic meanings, such as phlegm germ feminine, nidus efficiency, and cavity closing rate. Conclusion The treatment effect through fiberbrochoscope with general chemothrapy is better than that of monomer general chemothrapy. Therefore this method is good for clinic popularizition.