CT定位下耐多药空洞型肺结核穿刺注药术探讨

目的探索耐多药空洞型肺结核病人CT定位下经皮肺穿刺空洞注药术的操作要点及其临床应用价值。方法临床确诊痰菌阳性耐多药的空洞型肺结核84例,在CT导向下根据自制体表定位标记带选择进针点、进针角度、进针路径行空洞内灌注给药。结果84例病人穿刺成功率100%,并发气胸3例,肺出血1例,皮下气肿1例。治疗后痰菌转阴率为91.7%,空洞好转率89.3%,空洞闭合率66.7%。结论CT引导下经皮肺穿空洞给药技术具有简单易行、直观、定位准确、并发症少等优点,对治疗痰菌阳性耐多药的空洞型肺结核具有重要的临床应用价值。

Exploration of Puncture and Injection Under CT-guided for Multi-drug Resistant Cavitary Pulmonary Tuberculosis

Objective To explore the technique and clinical value of percutaneous lung puncture and injection of drug under CT-guided in the treatment of multi-drug resistant cavitary pulmonary tuberculosis(MDR-TB).Methods 84 patients of positive sputum smear with MDR-TB were undergone injecting drugs into the pulmonary cavities by percutaneous lung puncture under CT-guided.The treatments were carried out by self-made locating mark which could confirm the appropriate puncture point,puncture angle and the puncture line.Results The operations of puncture in all cases were successful,the complications included pneumothorax in 3 cases,pulmonary hemorrhage in 1 case and subcutaneous emphysema in 1 case.After treatment,the mean rate of sputum negative,improvement of pulmonary cavity and cavity closure was 91.7%,89.3% and 66.7% respectively.Conclusion The percutaneous pulmonary puncture and injection of drug under CT-guided was a simple,visualized,right localization and less complications method in the treatment of the MDR-TB.