经皮肺穿刺空洞内置管注药治疗耐多药空洞肺结核疗效观察

The clinical research of percutaneous pulmonary cavity catheterization injection therapy in treatment of multi-drug resistant tuberculosis with pulmonary cavity

目的探讨经皮肺穿刺空洞内置管注药治疗耐多药空洞肺结核的临床疗效。方法经皮耐多药肺结核空洞内穿刺并留置中心静脉导管,每周2次向空洞内注入针剂异烟肼、丁胺卡那霉素、左氧氟沙星,10次为个疗程,并加口服及静脉注射化疗23例,与单纯口服及静脉注射化疗28例进行对比分析。结果经皮肺穿刺空洞内置管注药试验组6个月疗程结束时痰菌阴转率78.3%,病灶治疗有效率71.4%,空洞治疗有效率82.6%,均显著高于单纯化疗对照组的46.4%,50%及46.4%(P<0.05)。结论经皮肺穿刺空洞内置管注药治疗耐多药空洞肺结核的临床疗效显著优于单纯化疗,并可减少多次穿刺所致并发症,减少患者痛苦,节省费用。

Objective To study the clinical effect of percutaneous pulmonary cavity catheterization injection therapy in treatment of multi-drug resistant tuberculosis （MDR-TB） with pulmonary cavity. Methods 23 patients were diagnosed MDR-TB with pulmonary cavity as test group. The patients in the test group were percutaneous punctured and indwelled within central venous catheter into pulnmna- ry cavity, 2 times a week injected with isoniazid,amikacin and levofloxacin in the cavity, for 10 times as a course of treatment, orally and intravenously simultaneously. Another 28 MDR-TB with pulmonary cavity patients were in the control group, and we treated them using o- ral and intravenous chemotherapy only. Result After 6 months at the end of treatment, the test group showed sputum negative with a conversion rate of 78. 3 % , of lesions effective rate of 71.4% and cavity recovery rate of 82. 6%. In the control group, the rates were respeetively 46.4% , 50% and 46.4%. The effect rates of the test group was significant higher than that of the control group （ P 〈 0. 05 ）. Condusion The clinical effect of MDR-TB using percutaneous pulmonary cavity catheterization injection is better for the test group than that for the control group, and the former also shows less complications and cost effectiveness.