经支气管镜局部药物注射治疗老年空洞型肺结核的临床研究

Clinical study of local drug injection through bronchoscope in the treatment of senile cavitary pulmonary tuberculosis

目的探讨经支气管镜局部药物注射治疗老年空洞型肺结核的临床疗效。方法选取本院2018年1月至2019年1月收治的74例老年空洞型肺结核患者作为研究对象,采用随机数字法分为观察组和对照组,各37例。对照组采用单纯化疗进行治疗,观察组在对照组基础上采用经支气管镜局部药物注射(异烟肼注射液+利福平注射液)进行治疗,比较两组临床疗效。结果治疗后1、2个月,观察组痰菌转阴率均高于对照组(P<0.05);治疗后3、6个月,两组痰菌转阴率比较差异无统计学意义。治疗后3、6个月,两组病灶空洞变化情况比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论经支气管镜局部药物注射治疗老年空洞型肺结核疗效显著,能有效控制病情发展,且预后良好,无严重不良反应,值得临床推广应用。

Objective To investigate the clinical efficacy of local drug injection through bronchoscope in the treatment of senile cavitary pulmonary tuberculosis.Methods 74 elderly patients with cave-type pulmonary tuberculosis admitted to our hospital from January 2018 to January 2019 were selected as study subjects,and they were divided into observation group and control group by random number method,with 37 cases in each group.The control group was treated with chemotherapy alone,while the observation group was treated with bronchoscopic local drug injection(isoniazid injection+rifampicin injection)on the basis of the control group.The clinical efficacy of the two groups was compared.Results 1 and 2 months after treatment,the sputum negative conversion rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in sputum negative conversion rate between the two groups in 3 and 6 months after treatment.3 and 6 months after treatment,the difference of lesion cavity change between the two groups was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups.Conclusion Bronchoscopic local drug injection in the treatment of cavitation pulmonary tuberculosis in the elderly is effective,can effectively control the development of the disease,and the prognosis is good,no serious adverse reactions,worthy of clinical application.