经皮肺穿刺注药治疗耐多药肺结核空洞的近远期疗效观察

目的 探讨CT引导经皮肺穿刺注药治疗耐多药空洞性肺结核的临床价值。方法将66例耐多药空洞性肺结核患者随机分为介入治疗组(33例)和单纯化疗组(33例)，介入治疗组采用经皮肺穿刺注药联合抗结核药物治疗，单纯化疗组单用抗结核药物治疗，观察近远期疗效。结果疗程结束时，介入治疗组痰菌阴转率（70%）、病灶吸收率（73.3%）、空洞闭合率（50%）明显高于单纯化疗组的41.9%、41.9%和19.4% (P<0.05)。2组完成疗程时痰菌阴转者经1～2年随访，各有1例复发，复发率分别为4.8%和6.3%，2组复发率比较差异无统计学意义(P>0.05)。介入治疗组无严重不良反应。结论CT引导经皮肺穿刺注药治疗耐多药空洞性肺结核的近期疗效有提高，操作安全，不良反应少。

The short-term and long-term clinical treatment outcome of CT-guided percutaneous lung centesis administration in treatment of cavernous multi-drug resistant pulmonary tuberculosis

Objective To evaluate the clinical treatment value of CT-guided percutaneous lung centesis administration in treatment of cavernous multi-drug resistant pulmonary tuberculosis. Methods 66 patients with cavernous multi-drug resistant pulmonary tuberculosis were randomized 1：1 to experimental group and control group. 33 patients in experimental group received CT-guided percutaneous lung centesis administration combined with antituberculosis treatment, and 33 patients in control group received anti-tuberculosis treatment alone. The short-term and long-term clinical treatment outcomes were observed. Results At the end of the treatment, the sputum negative conversion rate was 70%, foci absorption rate was 73.3% ,and cavity closure rate was 50% in the experimental group, all of which were higher than those of the controls （41.9%,41.9%and 19.4%） （P〈0.05）. The patients with the sputum negative conversion at the end of the treatment in two groups were followed up for 1～2 years, and one case was recurrent in each group（4.8% and 6.3%）. There was no statistically significant difference on recurrent rates in two groups （P〉0.05）. There were not severe adverse reactions observed in the experimental group. Conclusion The short-term and long-term clinical treatment outcome of CT-guided percutaneous lung centesis administration in treatment of cavernous multi-drug resistant pulmonary tuberculosis were both better than those of the routine antitubereulosis treatment alone. The combined treatment approach was safe and has few side effects.