彩色多普勒超声引导下经皮穿刺注药治疗肺结核96例效果观察

Curative effect of 96 tuberculosis cases treated by percutaneous injection drug guided by color Doppler ultrasound

目的探讨彩色多普勒超声引导下经皮穿刺空洞内注药治疗耐药结核病的疗效。方法将96例细菌学培养阳性的耐药结核病患者随机分为治疗组48例，对照组48例，两组患者均采用全身抗结核治疗，治疗组加用彩色多普勒超声引导下空洞内注药，比较两组临床疗效。结果治疗3个月治疗组痰菌阴转率、x线胸片吸收率、空洞闭合率、空洞有效率均高于对照组，差异均有统计学意义[56．3％（27／48）与35．4％（17／48）、81．3％（39／48）与62．5％（30／48）、58．3％（28／48）与37．5％（18／48）、75．0％（36／48）与50．o％（24／48）；x2值分别为4．20、4．17、9．58、6．40，P值分别为0．024、0．041、0．004、0．020）。治疗12个月治疗组痰菌阴转率、空洞闭合率、空洞有效率高于对照组差异均有统计学意义[93．8％（45／48）与77．1（37／48）％、83．3％（40／48）与62．5％（30／48）、95．8％（46／48）与81．3％（39／48）；∥值分别为5．35、5．27、5．03，P值分别为0．040、0．038、0．025]。治疗组胸片吸收率为93．8％（45／48），高于对照组的83．3％（40／48），但差异无统计学意义（x2=2．56，P=0．199）。结论彩色多普勒超声引导下经皮肺穿刺空洞内注药治疗耐药结核病疗效显著，且无明显并发症和不良反应发生。

Objective To explore the curative effect of percutaneous cavity injection for the treatment of drug resistant pulmonary tuberculosis guided by color Doppler ultrasound. Methods Ninety-six bacterial culture positive patients with drug resistant pulmonary tuberculosis were randomly divided into treatment group（n = 48 ） and control group （ n = 48 ）. Patients in both groups were given systemic anti tuberculosis therapy, and those who in the treatment group were given extra percutaneous cavity injection guided by color Doppler ultrasound. Results After 3 months of treatment, the sputum negative conversation rate, X-ray absorption rate, cavity closure rate, and cavity efficiency rate of the treatment group were 56. 3% （27/48）,81.3% （39/48）, 58.3% （28/48） and 75.0% （36/48） respectively, higher than those of the control group 35.4% （ i7/48）, 62. 5% （ 30/48 ）, 37.5% （ 18/48 ） and 50. 0% （ 24/48 ） respectively ）, and the differences were statistically significant （ X2 =4. 20,P =0. 024;X2 =4. 17,P =0. 041 ;X2 =9. 58,P =0. 004;X2 =6. 40,P =0. 020）. After 12 months of treatm6nt, the sputum negative conversation rate, cavity closure rate, cavity efficiency rate of the treatment group were 93.8% （ 45/48 ）, 83.3% （ 40/48 ）, 95.8% （ 46/48 ） respectively, higher than those of control group（77.1% （37/48） ,62. 5% （30/48） and 81.3% （39/48）） ,and there were significant differences between two groups （ X2 = 5. 35,5. 27, 5.03 ; P = 0. 040,0. 038,0. 025 ） ; the X-ray absorption rate of the treatment group was 93.8% （45/48）, higher than that of ciontrol group （83.3% （40/48） ）, but there was no significant difference between two groups（ X2 = 2. 56 ,P = 0. 199）. Conclusion It is very effective to treat drug resistant pulmonary tuberculosis using percutaneous cavity injection guided by Color Doppler Ultrasound. No obvious complications or adverse reactions have been observed so far.