纤维支气管镜下局部注药治疗耐多药肺结核病的疗效观察

目的探讨耐多药肺结核纤维支气管镜(简称纤支镜)下注药加化疗的临床疗效。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,再注入丁胺卡那(A)、左氧氟沙星(V)、异烟肼(H)注射液,配合全身化疗治疗耐多药肺结核42例,与单纯全身化疗39例进行对照研究。结果经纤支镜注药治疗组满9个月时痰菌阴转率85.7%,病灶有效率88.1%,空洞闭合率40.5%。均显著高于单纯全身化疗组的64.1%,66.7%及17.9%(P<0.01,P<0.05)。结论经纤支镜注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,而且未见严重的并发症和毒副反应。

Study on effect of bronchofiberscope and catheter intervention in multi-drug resistance pulmonary tuberculosis

To determine the effect of bronchofiberscope and catheter intervention combined with chemotherapy in the multi-drug resistance pulmonary tuberculosis. 42 cases were treated by injecting amikacin, levofioxacin and isoniazid, after cleaning up exudation and bacifing local environment through bronchofiberscope with chemotherapy, while 39 cases controls were treated by chemotherapy only. By the end of 9 months, the sputum tubercle bacillus conversion rate, radiagraphical improvement rate and cavity closing rate were 85.7%, 88.1% and 40.5% respectively in the treated groups, while all these indications were higher than control group 64.1%, 66.7% and 17.9%(P<0.01, P<0.05). No complications and obvious adverse reactions were observed. [Conclusions] Bronchofiberscope and catheter intervention combined with chemotherapy is safe and more effective than simple chemotherapy in the treatment of MDR-TB.