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  

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

作　　者：唐神结[1] 肖和平[1] 李红[1] 桂徐蔚[1] 顾瑾[1] 粱莉[1] 孙华[1] 闫丽萍[1] 

机构地区：[1]同济大学附属上海市肺科医院,上海市结核(肺)重点实验室,上海200433

出　　处：《中国防痨杂志》2009年第2期94-99,共6页Chinese Journal of Antituberculosis

摘　　要：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。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.

关 键 词：结核 肺 结核 抗多种药物性 穿刺术 

分 类 号：R521[医药卫生—内科学]