无痛纤支镜治疗空洞型肺结核的临床护理

目的：探讨无痛纤支镜给药治疗空洞型肺结核的护理方法,探索空洞型肺结核短程化疗实施路径。方法：采用随机配对分组法,将126例空洞型肺结核患者分为治疗组（M组,63例）和对照组（C组,63例）。化疗方案：M组3HRZEAK/6HRE,另通过无痛纤支镜给药,强化期每周1次;C组不用纤支镜给药,化疗方案同M组。结果：强化期结束时,M组与C组痰菌阴转率分别为92.06%和49.21%,2组之间的差异具有统计学意义（χ2=27.894,P〈0.01）;空洞闭合率分别为67.67%和30.16%,2组之间的差异具有统计学意义（χ2=16.811,P〈0.01）。疗程结束时,M组与C组痰菌阴转率分别为98.00%和63.49%,组间差异具有统计学意义（χ2=24.912,P〈0.01）;空洞闭合率分别为92.06%和46.03%,组间差异具有统计学意义（χ2=31.231,P〈0.01）。结论：无痛纤支镜给药治疗空洞型肺结核,可使痰菌转阴和空洞闭合的时间缩短,9个月短程化疗安全可靠,效果满意。

Nursing for Painless Fibrobronchoscopy in Treating Cavernous Pulmonary Tuberculosis

Objective： To approah the nursing method for painless fibrobronchoscopy in the treatment for cavernous pulmonary tuberculosis and explore implementation path of short-course chemotherapy.Method： All 126 patients were randomly allocated to treatment group（M group） and control group（C group） with the random pairing method.Chemotherapy plan： M group 3HRZEAK/6HRE,administered through fibrobronchoscopy,once each week in the intensive period;chemotherapy plan of C group was the same with M group.Result： After intensive period finished,the sputum conversion rates of M group and C group were respectively 92.06%and 49.21%,comparison between both groups demonstrated statistical meaning（χ 2 =27.894,P〈0.01）;closing rates of pulmonary cavities were 67.67% and 30.16%,comparison between both groups suggested statistical meaning（χ 2 =16.811,P〈0.01）. When the session ended,the sputum conversion rates of M group and C group were respectively 98.00% and 46.03%,comparison between both groups demonstrated statistical meaning（χ 2 =24.912,P〈0.01）;closing rates of pulmonary cavities were 92.06% and 46.03%,comparison between both groups suggested statistical meaning（χ 2 =31.231,P〈0.01）.Conclusion： Painless fibrobronchoscopy in treating cavernous pulmonary tuberculosis could shorten the sputum conversion time and closing time of pulmonary cavities.Short-course chemotherapy for nine months is safe and reliable and could obtain satisfactory results,which should be widely used in clinic.