经气道介入药物凝胶治疗耐多药肺结核35例报告

Bronchofiberscope and Catheter Intervention in Treatment of Multi-drug Resistant Pulmonary Tuberculosis(35 cases Report)

目的 探讨纤维支气管镜导管介入对耐多药肺结核的治疗价值。方法 经纤维支气管镜导管介入空洞病灶内注入异烟肼、利福平、吡嗪酰胺及卷曲霉素组成的药物凝胶。加化疗治疗耐多药肺结核 35例 ,与单纯化疗 35例进行对照研究。结果 经纤维支气管镜导管介入治疗组疗程结束痰菌阴转率 88 5 % ,病灶显效率82 9% ,空洞闭合率 31 4 % ,显著高于单纯化疗组的 5 1 6 4%、4 5 7%、11 4 %。结论 经纤维支气管镜导管介入空洞病灶内注药加化疗治疗耐多药肺结核 ,疗效显著优于单纯化疗 。

Objective To evaluate the clinical value of bronchofiberscope and catheter intervention in treatment of multi-drug resistant pulmonary tuberculosis.Methods Thirty-five patients with multi-drug resistant pulmonary tuberculosis were treated by injecting drug gel,it was composed by rimifon and rifampin and aldinamide and capreomycin through bronchofiberscope and catheter in addition to chemotherapy,while thirty-five controls were treated by chemotherapy only.Results At the end of the treatment,the sputum bacterial conversion to negative rate was 88 5%,radiographic improvement rate was 82 9% and cavity closing rate was 31 4% in the treatment group,all of which were higher than in the controls(51 4%,45 7% and 11 4% respectively)(P<0 01～0 05).Conclusions The efficacy of bronchofiberscope and catherter intervention in addition to chemotherapy is better than only chemotherapy in treatment of multidrug resistant pulmonary tuberculosis.No obvious complication and adverse reaction were observed.