利福平注射液经纤维支气管镜治疗支气管结核的临床疗效分析

The clinical analysis of rifampicin injection in the treatment of bronchial tuberculosis by using fiberoptic bronchoscopy

目的探讨分析利用纤维支气管镜在气道局部病灶注射利福平治疗支气管结核（EBTB）的临床疗效。方法选择2012年3月～2013年1月我院呼吸内科收治的74例EBTB患者，按照治疗意愿分为对照组与观察组，对照组34例患者行常规抗结核治疗，观察组40例患者在对照组常规结核治疗基础上．对患者行纤维支气管镜介入在气道局部注射利福平注射液。结果两组EBTB患者发热、咳嗽、咳痰等临床症状均得到不同程度改善。观察组转阴率为100％（40／40），对照组转阴率为94．1％（32／34），两组患者的痰检转阴率比较，差异无统计学意义（x2：0．935，P=-O．353）；纤维支气管镜介入气道局部注射给予利福平患者的好转率为100％，对照组好转率为82．4％，两组好转率比较，差异有统计学意义（X2=17．955，P〈0．05）；观察组与对照组患者治疗后总有效率分别为97．5％与79．4％，差异有统计学意义（P〈0．05）。结论纤维支气管镜介入气道局部注射给予利福平治疗EBTB的疗效确切，安全有效，不良反应少，能减少支气管狭窄、肺不张、毁损肺的发生，提高生活质量，值得临床进一步推广。

Objective To investigate and analyze the clinical efficacy of injecting of rifampicin to cure bronchial tuber- culosis （EBTB） by using fiberoptic bronehoscope in the airway local lesion. Methods Seventy-four cases of EBTB pa- tients in our respiratory medicine were divided into the control group and observation group according to their inten- tion. The control group of 34 patients underwent conventional anti-TB treatment, and the 40 patients of observation group were injected rifampicin injection to cure bronchial tuberculosis （EBTB） using fiberoptic bronchoscope in the airway local lesion on the basis of the treatment in the control group. Results The clinical symptoms such as fever, cough and expectorion of the two groups were improved to varying degrees. Turn rate of the control group and observa- tion group were 94.1% （32/34） and 100% （40/40） respectively, there was no statistically significant difference （~2= 0.935, P = 0.353）; The improvement of observation group was 100%, while it was 82.4% in the control group. The dif- ference between the two groups was statistically significant compared with improvement rate （X2=17.955, P 〈 0.05）; The total effective rates of the control group and observation group were 79.4% and 97.5% respectively, the difference was statistically significant （P 〈 0.05）. Conclusion Injecting rifampicin injection by using fiberoptic bronchoscopy in airway local can give EBTB curative effect, is safe and effective, has less adverse reactions and can reduce bronchial stenosis, atelectasis and the incidence of lung damage and can improve the quality of life and is worthy of further pro- motion.