耐多药空洞型肺结核两种治疗方法疗效分析

目的比较纤维支气管镜介导注药和常规方法治疗耐多药肺结核的疗效。方法将120例耐多药肺结核患者依治疗方法分为纤维支气管镜组（60例）和常规组（60例）。两组均行全身常规抗痨治疗。纤维支气管镜组在电视透视下经纤维支气管镜导管介入空洞并注入左氧氟沙星、丁胺卡那霉素、异烟肼抗痨药物。比较两种治疗方法的疗效。结果两组耐多药肺结核患者的耐药情况差异无显著性（F=4．23，P〈0．05）；治疗1、3、6、9个月后纤维支气管镜组痰菌阴转率均明显高于常规组（F=4．59，4．56，5．12，5．33；P均〈0．01）；患者治疗9个月后纤维支气管镜组病灶吸收率和空洞闭合率均高于常规组（F=4．51，4．78；P均〈0．01）；纤维支气管镜组并发症发生17例（28．3％）高于常规组（10．3％）（F=5．12，P〈0．05）；治疗3个月纤维支气管镜组有效率（88．4％）明显高于常规组（58．1％）（F=4．77，P均〈0．05）。结论经纤维支气管镜组介导注药治疗耐多药肺结核的疗效优于常规全身化疗。

Compa rison of Therapeutic Effect of Two Methods on Patients with MDR-TB

Objective To analyse the therapeutic effect and complications of the catheter intervention and the routine in multi-drug resis, tance pulmonary tuberculosis（MDR-TB）. Methods 120 patients with MDR-TB were separated into two groups： the bronchofiberscope group （60 cases） and the simple chemotherapy group （60 cases）. The two groups were all under anti-tuberculosis treatment. The patients in the bronchofiberscope group were treated by injecting amikacin, levofioxacin and isoniazid into the cavity catheter intervention. Compare the thempeutic effect and the complications caused by the intervention between the two groups. Results Two groups of MDR-TB drug resistance in patients with no significant difference（F = 4.23, P 〈 0.05 ）; Enriched months after treatment group bron-choscopy sputum negative rate were significantly higher than the conventional group（F= 4.59,4.56,5.12,5.33 ;P〈 0.01 ）;With nine months after treatment group bronchoscopy focus absorption rate and pore closure rates were higher than the conventional group （F = 4.51,4.78 ;P 〈 0.01 ） ; Bronchoscopy complication occurred in 17 patients（28,3% ） than in the convehtional group（ 10.3% ）（F = 5.12, P 〈 0.05 ）; for three months bronchoscopy group efficiency （88.4%） was significantly higher than that of the conventional group （58.1% ） （ F = 4.77, P 〈 0.05 ）. Conclusion Bronchofiberscope group mediated injection in the treatment of MDR-TB effect is superior to the conventional systemic chemotherapy.