86例多耐药空洞型肺结核介入辅助治疗的成效分析  

Therapeutic effect of 86 multi-drug resistant cavernous pulmonary tuberculosis by interventional therapy

作　　者：贾育红[1] 刘新[1] 

机构地区：[1]河南省胸科医院

出　　处：《中国感染控制杂志》2009年第1期10-13,共4页Chinese Journal of Infection Control

摘　　要：目的探讨经纤维支气管镜进行结核空洞注药治疗耐多药肺结核的临床疗效。方法在X线透视下经纤维支气管镜导管介入空洞注入左氧氟沙星、阿米卡星、异烟肼、吡嗪酰胺等抗结核药物，加全身化学治疗（化疗）治疗耐多药肺结核患者86例（治疗组），并与单纯化疗的94例患者（对照组）进行对照研究。结果治疗组痰菌转阴率在治疗1个月、3个月、6个月后分别为17．44％、65．11％、87．21％，显著高于对照组的0.00％、30．85％及55．32％（两两比较，均P〈0．01）。治疗3个月后，治疗组病灶显效（显著吸收＋吸收）率为95．35％，空洞闭合率为38．37％，显著高于对照组的58．51％及13．83％（两两比较，均P〈0．01）。结论全身化疗加经纤维支气管镜导管介入空洞内局部注药治疗耐多药肺结核，疗效显著优于单纯全身化疗。Objective To investigate therapeutic effect of interventional injecting medicines through fiberbronchoscope on multi drug resistant cavernous pulmonary tuberculosis （MDR-TB）. Methods Eight-six patients （treatment group） with cavernous pulmonary MDR TB were treated with both injecting levofloxacin, amikacin, isoniazid, pyrazinamide through fiberbronchoscope catheter and routine chemotherapy, 94 cases in the control group were only given routine general chemotherapy. Results After 1,3,6 months treatment, the sputum negative conversion rate in treatment group was 17. 44%, 65. 11% and 87.21 % respectively, which were significantly higher than those in control group（0. 00%, 30. 85 % and 55.32%）respectively（P〈0. 01）. After 3 months treatment, the effective rate in treatment group was 95.35%, cavity closure rate was 38. 37%; which were significantly higher than those in control group （58. 51% and 13. 83%） respectively （P〈0. 01）. Conclusion The therapeutic effect of MDR-TB treated with intervention injecting drugs in cavity by fiberbronchoscope and routine chemotherapy is superior to only routine chemotherapy.

关 键 词：结核 肺 结核分枝杆菌 抗药性 微生物 耐多药结核 抗结核治疗 介入疗法 纤维支气管镜 

分 类 号：R521[医药卫生—内科学]