抗痨凝胶介入治疗耐多药肺结核空洞的疗效分析

Therapeutic effect of interventional injecting antiphthisic gel on multi-drug resistant cavernous pulmonary tubercu-losis

目的探讨经纤维支气管镜进行结核空洞注药治疗耐多药肺结核的临床疗效。方法在X线透视下经纤维支气管镜导管介入空洞注入抗痨凝胶，加全身化学治疗（化疗）治疗耐多药肺结核患者89例（治疗组），并与单纯化疗的91例患者（对照组）进行对照研究。结果治疗组痰菌转阴率在治疗3个月、6个月、18个月后分别为62．92％、76．40％、88．76％，显著高于对照组的26．37％、42．86％及56．04％（两两比较，均P〈0．01）。治疗18个月后，治疗组病灶显效率（显著吸收率＋吸收率）为93．26％，空洞闭合率为41．57％，显著高于对照组的63．74％及15．38％（两两比较，均P〈0．01）。结论全身化疗加经纤维支气管镜导管介入空洞内局部注药治疗耐多药肺结核，疗效显著优于单纯全身化疗。

Objective To investigate therapeutic effect of interventional injecting antiphthisic gel through fiberbronchoscope on multi-drug resistant cavernous pulmonary tuberculosis （MDR-TB）. Methods Totally 89 pa- tients （treatment group） with cavernous pulmonary MDR-TB were treated with both injecting antiphthisic gel through fiberbronchoscope catheter and routine chemotherapy; 91 cases in the control group were only given routine general chemotherapy. Results After 3,6,18 months treatment, the sputum negative conversion rates in treatment group was 62.92% ,76.40% and 88.76% respectively, which was significantly higher than those in control group （26.37% ,42.86% and 56.04% ） respectively （P 〈 0.01 ）. After 18 mouths treatment,the effective rate in treatment group was 93.26% and cavity closure rate was 41.57%, which were significantly higher than those in control group （63.74% and 15.38% ） respectively （P 〈 0.01 ）. Conclusions The therapeutic effect of MDR-TB treated with intervention injecting antiphthisic gel in cavity by fiberbronchoscope and routine chemotherapy is superior to routine chemotherapy alone.