高浓度大剂量局部灌注给药治疗耐多药肺结核

目的　探讨经纤支镜高浓度大剂量药物灌注治疗耐多药肺结核的疗效及安全性。方法 将 60例耐多药肺结核随机分为治疗组和对照组,治疗组强化期第 1月经纤支镜高浓度大剂量左氧氟沙星(0.2%,60～120mL)病灶灌注加全身化疗,对照组强化期第 1、2月经纤支镜常规浓度剂量左氧氟沙星 (0.1%,10～20mL)病灶灌注加化疗。结果 强化期结束时,治疗组痰菌阴转率 96.7% (2930),病灶显著吸收率 83.3% (2530),明显高于对照组的 73.3% (2230)和 53.3% (1630) (P均＜0.05)。痰菌阴转平均时间治疗组 32.5d,比对照组 56.5d明显缩短 (P＜0.01)。结论 经纤支镜高浓度大剂量局部灌注给药治疗耐多药肺结核,疗效优于常规灌注,且疗程短、费用低、无并发症,安全可行。

High concentration and large dose perfusion on treatment of multi-drug resistance pulmonary tuberculosis

Objective To evaluate the clinical value and safety of high concentration and large dose perfusion on treatment of multi drug res istance pulmonary tuberculosis.Methods Sixty patients with multi drug resistant pulmonary tub erculosis cases were randomly divided into an experiment and control group.The experiment group was treated by perfusion with levofloxacin (0.2%,60～120 mL) and general antituberculosis chemotherapy.The control group was treated by injecting levofloxacin (0.1%,10～20 mL) and general antituberculosis chemotherapy. Results At the end initial phase of treatment,the sputum conversion rate was 96.7%,foci marked absorption rate was 83.3% in the experiment group,all of which were higher than that of the control’s (73.3% and 53.3% respectively, P＜0.05).Sputum conversion time (32.5 d) in the experiment group was shorter than that of the controls (56.5 d)(P＜0.01). Conclusion The efficacy of the high concentration and large dose perfusion is better than the routine injection in the treatment of multi drug resistance pulmonary tuberculosis.The treatment course was shorted.The expense was lower.No complication and obvious adverse reaction were observed.