纤维支气管镜导管介入治疗重症肺结核

BRONCHOFIBERSCOPE AND CATHETER INTERVENTION IN TREATMENT OF SERIOUS PULMONARY TUBERCULOSIS

目的：探讨纤维支气管镜导管介入对重症肺结核的治疗价值；方法：６２例重症肺结核住院患者随机分为治疗组３２例及对照组３０例。两组均给于常规治疗，即口服及静脉抗结核化疗加用扩血管药及免疫制剂，合并感染者用抗生素。治疗组经纤维支气管镜导管介入病灶内注入抗结核药。对比观察两组疗效；结果：治疗组退热率１００％、呼吸衰竭治愈率１００％、痰菌阴转率８８％、病灶显效率８４％及空洞有效率７７％，均显著高于对照组的２５％、６７％、５２％、５３％及５２％（Ｐ＜０．０１～０．０５）。治疗组无死亡病例，对照组死亡６例，治疗组病死率显著低于对照组（Ｐ＜０．０５）；结论：纤维支气管镜导管介入病灶内注药加常规治疗重症肺结核，疗效优于常规治疗。

Objective: To evaluate the clinical value of bronchofiberscope and catheter intervention in treatment of serious pulmonary tuberculosis.Methods: 62 patients with serious pulmonary tuberculosis were randomly divided into 2 groups.Both the treatment group(n=32) and the control group (n=30) were given routine therapy of oral and intravenous antituberculosis added vasodilator and immunopotentiator,if complicated infection,added antibiotics.The patients of treatment group were treated by injecting antitubercular drugs through bronchofibercope and catheter.The clinical results were comparatively observed.)Resulst: The pyretolysis rate was 100%,cure rate of respiratory failure 100%,sputum conversion rate 88% radiographic improvement rate 84% and cavity effective rate 77% in the treatment group,all of which were higher than controls (25%,67%,52%,53%,and 52% respectively)(P<0 01～0 05)。The mortality rate in the treatment group was lower than the control one (P<0 05).Conclusions: The efficacy of bronchofiberscope and catheter intervention in addition to routine therapy is better than only routine therapy in treatment of serious pulmonary tuberculosis,quick and prominent especially in the pyretolsis and curing respiratory failure.