耐多药肺结核经支气管镜介入治疗的远期效果研究

目的探讨经支气管镜介入配合全身化疗治疗耐多药肺结核（MDR-TB）的效果。方法经痰结核菌培养确定的复治耐多药肺结核患者随机分为三组，均采用3DZVThAk／15DVTh化疗方案治疗，治疗组同时使用不同药物进行支气管镜介入治疗。结果满疗程时，治疗组痰菌阴转率（涂片与培养）、病灶显著吸收率、空洞闭合率明显优于对照组；随访2年，对照组复发率高于治疗组。结论经支气管镜介入治疗联合全身化疗对耐多药肺结核疗效显著优于单纯全身化疗，能促进痰菌阴转、病灶吸收、空洞闭合，值得推广。

A Study of Interventional Treatment Through Bronchofiberscope on MDR-TB

Objective To explore the curative effect of bronchofiberscope interventional treatment combined with ehemotheropy on multi- drug resistant pulmonary tuberculosis （MDR-TB）. Methods The retreated MDR-TB patients were defined by the test of cultured drug-resistant TB strains,and divided into a treatment group and a control group at random. Both the groups received chemotheropy of 3DZVThAk/15DVTb. The former took interventional treatment through bronchofiberseope at the same time. Results At the eighteenth month end of treatment, the sputum （smear and culture） netative conversion rates,the remarkable effective rates in chest X-ray,the cavity closing rates of two treatment groups were more significant than the control group. The sputum smear positive conversion rates of the control group were higher than that of the treatment groups in 24 months of followed-up. Conclusion The curative effect was remarkable for bron- chofiberscope-assisted interventional treatment combined with chemotheropy on MDR-TB patients. It is very effective in sputum netative conversion,lesion absorption and the cavity closure, and it is worthy of approaching extensively.