肺结核空洞的影像学改变与疗效的相关性研究

目的通过对肺结核空洞的影像学表现与肺结核治疗疗效的相关性分析,为临床治疗提供帮助,同时预测其预后。方法回顾性分析佛山市顺德区慢性病防治中心收治的200例初治涂阳的肺结核患者,其中选择初治涂阳空洞型肺结核100例作为实验组,初治涂阳非空洞型肺结核100例作为对照组。两组均按照2HRZE/4HR方案进行治疗,通过影像学动态观察空洞的性质、大小、壁厚的改变及对疗效的影响。结果治疗组2个月后痰菌转阴率为82%,6个月后痰菌转阴率为90%,治疗失败者5例,占5%。对照组2个月后痰菌转阴率为88%,6个月后痰菌转阴率为95%。本组病例中厚壁空洞63例(其中78.5%洞壁厚薄不均),薄壁空洞37例,有22例伴有壁内结节,与癌性空洞相似,单发空洞54例,多发空洞46例。肺结核空洞在化疗过程中与治疗后的动态变化:①空洞逐渐缩小最后吸收者78例;②转化为净化空洞者13例;③形成纤维性空洞者1例;④形成结核瘤者3例;⑤治疗失败者5例。结论肺结核空洞经化疗后转归有一定的规律,影像学动态观察对其诊断与疗效评价具有重要价值。

The Correlation Study of Tuberculosis Empty Image Changes with the Efficacy

Objective Through analysis the correlation of tuberculosis empty tuberculosis imaging and tuberculosis therapy,to help clinical treatment help and predict the prognosis.Methods Retrospective analysis of 200 cases admitted to Shunde chronic diseases prevention and cure center smear-positive TB patients,in which select smear 100 cases of cavitary pulmonary tuberculosis as the experimental group,smear-positive non-cavitary tuberculosis 100 cases as control group.Both groups were treated in accordance with 2HRZE/4HR program,through the imaging dynamic to observe the empty nature,size,wall thickness changes and the impact on efficacy.Results After 2 months the sputum negative conversion rate of treatment group was 82%,after 6 months was 90%,treatment failure in 5 cases,accounting for 5%.After 2 months the sputum negative conversion rate of the control group was 88%,after 6 months was 95%.The thick-walled cavity cases was 63（of which 78.5% tunnel wall thickness of inequality）,thin-walled cavity in 37 cases,22 cases with intramural nodule,similar to cancerous hole,54 cases of single and multiple cavity 46 cases.Hole in the chemotherapy of tuberculosis after the treatment process with the dynamic changes：①hole gradually shrinking the final absorber 78 cases;②into a clean empty 13 cases;③the formation of fibrous cavity in 1 case;④ the formation of tuberculoma in 3 cases;⑤treatment failure in 5 cases.Conclusion Tuberculosis empty after chemotherapy have certain vesting laws of dynamic observation of imaging diagnosis and efficacy evaluation of its great value.