肺结核合并支气管内膜结核个体化疗程的探讨

目的:探讨肺结核合并支气管内膜结核的治疗的合理性。方法:对164例初治涂阳肺结核经纤支镜检查确诊的支气管内膜结核病人,在异烟肼(H)、利福平(R)、吡嗪酰胺(Z)、乙胺丁醇(E)化疗至少2mon的基础上同时每周一次行纤支镜局部治疗,直至痰菌转阴。对治疗2mon以上痰菌未转阴者继续强化治疗直至痰菌转阴。以痰菌转阴为界用HR巩固治疗3mon。结果:满疗程痰菌转阴率达98.78%,平均化疗期达4.52mon。经2年随访,细菌学复发率为1.23%。结论:初治涂阳肺结核合并支气管内膜结核辅以纤支镜局部治疗4.52mon可取得与2HRZE/4HR相同的远期痰菌转阴率。提示:肺结核合并支气管内膜结核采用新方法治疗即可缩短疗程,节约经费,减少副作用,疗效可靠。

A Probe of Chemotherapic Course of Individual Care for Pulmonary Tuberculosis Combined with Endobronchial Tuberculosis

Objective: To search for the rationality of the treatment of pulmonary tuberculosis combined with endobronchial tuberculosis.Method: To the 164 patients who had been diagnosed with fiberopic bronchoscope as Endobronchial Tuberculosis,we basically treat them with isoniazidum(H),pifampin(R),pyrazinamidium(Z),ethambutol(E) for 2 months,meanwhile,we use fiberopic bronchoscope weekly to cure the pathological area until the smear turns negative. To the patients whose smears are still positive,although being given a 2 months therapy,we will intensify the therapy until it turns negative.In other case, we strengthen the treatment for 3 months on the boundary result.This phase includes a tow month intensive period.Results: The rate of patients whose smears turned negative reaches 98.78%,and the average course of treatment took 4.52 months.Through a followed visit of the patients in the two years period ,the rate of recurrence in bacteriology reached 1.23%. Conclusion: The treatment of fiberopic bronchoscope for 4.52 months has gained the same effect compared with the 2 HRZE/4HR therapy.Indication The new treatment for Pulmonary Tuberculosis combined with Endobronchial Tuberculosis can shorten the time required,economize the expenses,reduce the side-effect,safe and reliable.[