经支气管镜局部灌注两性霉素B治疗肺部真菌感染的临床研究

Clinical study of trans-bronchoscope local perfusion of amphotericin B in the treatment of pulmona-ry fungal infection

目的探讨经支气管镜局部灌注两性霉素B治疗肺部真菌感染的疗效。方法选择22例确诊肺部真菌感染的患者，随机分为两组：治疗组11例全身应用伏立康唑（4mg／kg，每12小时给药1次）联合给予经支气管镜灌洗后，两性霉素B25mg＋生理盐水10ml局部保留灌注治疗；对照组11例全身应用伏立康唑（4mg／kg，每12小时给药1次），维持至治疗结束。结果治疗组有效率为81．8％，明显高于对照组的54．5％，差异有统计学意义（P〈0．05），且无明显不良反应。结论经支气管镜肺泡灌注两性霉素B治疗肺部真菌感染安全、疗效好、疗程短、经济。

Objective To evaluate the efficacy of trans-bronchoscope local perfusion of ampho-tericin B on the treatment of pulmonary fungal infection. Methods Twenty-two patients with pulmonary fungal infection were randomly divided into two groups ： Patients in treatment group （ 11 cases） were given systemic application of voriconazole （4 mg/kg, once every 12 hours） combined with broncboseope local perfusion amphotericin B 25 mg and 10 ml physiological saline; Patients in control group（ 11 cases） were given systemic application of voriconazole （4 mg/kg, once every 12 hours）. Results The effective rate of treatment group （ 81.8 % ） was higher than that of control group （54.5 % ）, the difference was statisti-cally significant （ P 〈 0.05 ） , and there was no significant adverse reactions occurred. Conclusions Bronchoscope alveolar perfusion of amphotericin B in the treatment of pulmonary fungal infection is safe and effective, economic and has short course.