含药凝胶经纤维支气管镜介入治疗耐多药结核性干酪性肺炎

目的 探讨和评价经纤维支气管镜导管注入含药凝胶治疗耐多药结核性干酪性肺炎的临床疗效。方法 从1999年3月-2005年1月共治疗9例耐多药结核干酪性肺炎，在全身应用以KOP为主的复治化疗方案的基础上。另在干酪性肺炎病变处肺段经纤维支气管镜介入导管注入含药凝胶，凝胶中每20mL中含帕司烟肼600mg，链霉素1000mg，吡嗪酰胺500mg，左氧氟沙星400mg，每次约15-20mL，一般隔用1次，共4-8次。结果 9例病人经过平均4．5个月的治疗，痰菌涂片及培养均阴转，原干酪样病灶大部分吸收好转，无严重不良反应出现。结论 含药凝胶介入治疗耐多药结核性干酪性肺炎是一种有效和安全的新方法。

Fiberoptic bronchoscopic interventional therapy of multi-drug resistant caseous tuberculous pneumonia with gel containing drugs

[Objectives] To evaluate the clinical effect of treating multi-drug resistant caseous tuberculous pneu- monia by introducing drug containing gd through fibercptic brcnchoscope. [Methods] From March 1999 to January 2005, we treated nine cases of multi-drug resistant tuberculous caseous pneumonia patients. In addition to systematic administration of KOP regime, focal application of drug conveying gel to lung segment with fibercptic bronchoscope. Each twenty-millillter gel contains Pasiniazid 600 milligram, streptomycin 1000 milligram, Pyrazinamide 500 milligram, and Levofloxacin 400 milligram. Fifteen to twenty milliliters were applied each time, done every fortnigh4 for four to eight times. [Results] Average duration of treatment in nine cases of patients was 4.5 months; both sputum smear and culture became negative for tuberculosis bacilli, most of the caseous loci disappeared. No serious adverse effect was observed. [Conclusion] Treating multi-drug resistant tuberous caseous pneumonia with drug-containing gel application by fiberoptic brcnchoscope is effective and safe. It is worthwhile to recommend it to colleagues.