卡波姆含药凝胶在耐多药肺结核治疗中的应用与评价

目的评价经纤支镜卡泼姆含药凝胶灌注治疗耐多药肺结核的临床疗效和安全性。方法耐多药肺结核患者103例，分为治疗组68例，用纤支镜含药凝胶灌注治疗和抗结核药物治疗；对照组35例，用抗结核药物治疗。观察近期和远期疗效。 结果治疗6个月后，治疗组和对照组痰菌阴转率分别为72.1%，49.6%；病灶治疗有效率分别为83.3%，57.1%；空洞治疗有效率分别为60.5%，41.6% (均P＜0.05) ；痰菌阴转时间分别为34.8，65.2 d(P＜0.01)。随访2 a后，治疗组和对照组痰菌阳转率分别为7.4%，14.3%，差异无显著性 (P＞0.05)。治疗组无严重药物不良反应。结论卡波姆是一种优良的药用辅料，纤支镜含药凝胶灌注治疗耐多药肺结核优于常规治疗方法。

Application and Evaluation of Carbomer for Therapy in Multi-drug Resistant Pulmonary Tuberculosis

Objective To evaluate the clinical curative efficacy and safety of treatment in multi-drug resistant pulmonary tuberculosis with carbomer(drug containing gelatin) perfused through fiberbronchoscope. Methods Sixty-eight patients were treated with drug containing gelatin perfused through bronchofiberscope and antituberculosis medication in experiment group.Other 35 patients were treated only with antituberculosis medication in control group.The clinical curative effects in the acute and follow-up stages were observed. Results At the end of six months therapy,the sputum negative conversion rate was 72.1%,foci marked absorption rate was 83.3%,and cavity effective therapy rate was 60.5% in the experiment group,all of which were significantly higher than those of the controls(49.6.%,57.1% and 41.6% respectively)(P<0.05).Sputum negative conversion time was 34.8 d in average in experiment group,which was significantly shorter than that of the controls(65.2 d),(P<0.01).At the final follow up after 2 years,the sputum positive conversion rate was 7.4% in experiment group and was 14.3% in control group,no significant difference between two groups(P>0.05).There was no severe adverse reaction in experiment group. Conclusion Carbomer is a fine auxiliary medicinal material.The drug containing gelatin perfused via fiberbronchoscope to treat multidrug resistance pulmonary tubercalosis is better than the routine medication.