化疗加人工气腹治疗耐多药肺结核的研究

目的 观察和评价人工气腹辅助治疗耐多药肺结核（MDR－PTB）的疗效。方法 经人工气腹加药物治疗MDR－PTB 22例,与单纯药物治疗24例进行对照。结果 经人工气腹治疗组疗程结束时痰菌阴转率86．4％,病灶吸收显效率90．9％,空洞闭合率89．5％,均显高于单纯药物对照组的33．3％、37．5％及35．3％（P＜0．01）,且无明显并发症及副反应。经最长3年、最短1年随访,治疗组和对照组细菌学复发率分别为5．3％和50．0％,差异有显性意义（P＜0．01）。结论 人工气腹加化疗治疗MDR－PTB,疗效显优于单纯化疗,有推广前景。

Study of artificial pneumoperitoneum in treatment of multidrug resistant pulmonary tuberculosis

To assess the therapeutic efficacy of artificial pneumoperitoneum in the treatment of multidrug resistant pulmonary tuberculosis(MDR PTB).Method Twenty two patients with MDR PTB were treated by artificial pneumoperitoneum therapy in addition to drug therapy,while 24 controls were treated by drug therapy only.Results At the end of the treatment,the sputum conversion rate was 86.4%,the radiographic improvement rate 90.9%,and the cavity closing rate 89.5% for the treatment group,which were significantly higher than the controls (33.3%,37.5%,35.3%,respectively) (p<0.01).No obvious complication and adverse reaction were observed.In the 1 to 3 year followup,the bacteriological relapase rates were 5.3% for the treatment group and 50.0% for the control group.Conclusion The efficacy of artificial pneumoperitoneum in addition to the drug therapy is better than the drug therapy only in the treatment of MDR PTB,a recommendation for a wider applicarion in MDR PTB.