经纤维支气管镜局部给药对耐多药肺结核病的治疗研究

目的　评价纤维支气管镜 (纤支镜 )局部给药配合全身化疗对耐多药肺结核病的治疗效果。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4%碳酸氢钠、丁胺卡那霉素(A)、氧氟沙星(O)、异烟肼(H)注射液 ,配合全身化疗治疗耐多药肺结核44例 ,与单纯全身化疗30例进行对照研究。结果 经纤支镜给药治疗组满9个月时痰菌阴转率93.2% ,病灶有效率90.9% ,空洞闭合率40.5%。均显著高于单纯全身化疗组的60.0% ,56.7%及16.1% (P＜0.01,P＜0.05)。结论 经纤支镜给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。

A study on the treatment of multi-drug resistant pulmonary tuberculosis with bronchofiberscope and catheter intervention after basified local environment

Objective To study the efficacy of brochofiberscope and catheter intervention combined with chemotherapy in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB).Methods 44 cases were treated by injecting amikacin,ofloxacin and isoniazid,after cleaning up exudation and bacifing local environment with NaHCO 3 through brochofiberscope and catheter combined with chemotherapy,while 30 controls were treated by chemotherapy only.Results By the end of 9 months,the sputum tubercle bacillus conversion rate,radiagraphical improvement rate and cavity closing rate were 93.2%?90.9% and 40.5% respectively in the treated groups,while all these indications were higher than control group 60%?56.7% and 16.1% (P＜0.01,P＜0.05).No complications and obvious adverse reactions were observed.Conclusion Brochofiberscope and catheter intervention combined with chemotherapy is safe and more effective than simple chemotherapy in the treatment of MDR-TB.