经纤维支气管镜局部给药对耐多药肺结核病的治疗研究

A study on the treatment of multi-drug resistant pulmonary tuberculosis with bronchofiberscope and catheter intervention after basified local environment

目的 评价纤维支气管镜 (纤支镜 )局部给药配合全身化疗对耐多药肺结核病的治疗效果。方法 将纤支镜导至病灶区或相应的段支气管 ,清除病灶分泌物后 ,再注入 4 %碳酸氢钠、丁胺卡那霉素 (A)、氧氟沙星 (O)、异烟肼 (H)注射液 ,配合全身化疗治疗耐多药肺结核 4 4例 ,与单纯全身化疗30例进行对照研究。结果 经纤支镜给药治疗组满 9个月时痰菌阴转率 93.2 % ,病灶有效率90 .9% ,空洞闭合率 4 0 .5 %。均显著高于单纯全身化疗组的 6 0 .0 % ,5 6 .7%及 16 .1% (P <0 .0 1,P <0 .0 5 )。结论 经纤支镜给药配合全身化疗治疗耐多药肺结核病 ,疗效显著优于单纯全身化疗 。

Objective To study the efficacy of brochofiberscope and catheter intervention combined with chemotherapy in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB).Methods 44 cases were treated by injecting amikacin,ofloxacin and isoniazid,after cleaning up exudation and bacifing local environment with NaHCO 3 through brochofiberscope and catheter combined with chemotherapy,while 30 controls were treated by chemotherapy only.Results By the end of 9 months,the sputum tubercle bacillus conversion rate,radiagraphical improvement rate and cavity closing rate were 93.2%?90.9% and 40.5% respectively in the treated groups,while all these indications were higher than control group 60%?56.7% and 16.1% (P<0.01,P<0.05).No complications and obvious adverse reactions were observed.Conclusion Brochofiberscope and catheter intervention combined with chemotherapy is safe and more effective than simple chemotherapy in the treatment of MDR-TB.