经支气管镜辅助灌注药物治疗难治性空洞型肺结核效果观察  

Clinical observation of bronchoscopy-assisted perfusion medication for patients with refractory cavitary pulmonary tuberculosis

作　　者：史海霞[1] 聂素军 杨瑞波 武瑞永 Shi Haixia;Nie Sujun;Yang Ruibo;Wu Ruiyong(Department of Outpatient,Hospital for In fectious Diseases,Handan City,Hebei 056003,China;不详)

机构地区：[1]河北省邯郸市传染病医院门诊部,056003 [2]河北省邯郸市传染病医院肺三科,056003

出　　处：《山西医药杂志》2020年第20期2735-2737,共3页Shanxi Medical Journal

基　　金：邯郸市科技局项目(1623208027ZC)。

摘　　要：目的探讨难治性空洞型肺结核患者采用经支气管镜辅助灌注药物治疗临床疗效。方法 80例难治性空洞型肺结核按照治疗方法不同将其划分为对照组与观察组,每组40例。对照组采用2HREZ (A)(LV)/4HR方案治疗,治疗12个月;观察组于对照组治疗基础上采用支气管镜辅助灌注药物治疗。记录2组患者病灶吸收、痰菌转阴率、空洞闭合率;记录2组患者治疗3、6、9、12个月时好转率;采用健康调查简表(SF-36量表)评价2组患者治疗前后生活质量,记录治疗期间不良反应。结果观察组病灶吸收率、痰菌转阴率及空洞闭合率明显高于对照组(P<0.05);观察组治疗3、6、9、12、12个月时好转率明显高于对照组(P<0.05)。2组患者治疗后生理机能、躯体疼痛、生理职能、总体健康、社会功能、情感职能、活力、精神健康评分明显高于治疗前,观察组治疗后各项生活质量评分明显高于对照组(P<0.05)。2组治疗期间不良反应率相比较差异无统计学意义(P>0.05)。结论2HREZ (A)(LV)/4HR方案治疗基础上采用经支气管镜辅助灌注药物治疗难治性空洞型肺结核效果显著且安全,值得推广。Objective To investigate the clinical efficacy of bronchoscopy-assisted perfusion medication in patients with refractory cavitary pulmonary tuberculosis.Methods Eighty cases of refractory cavitary tuberculosis were divided into control group and observation group according to different treatment methods,40 cases in each group.The control group was treated with 2HREZ(A)(LV)/4HR regimen for 12 months.The observation group was treated with bronchoscopy-assisted perfusion medication based on the control group.The lesion absorption,sputum negative rate and cavity closure rate of the two groups were recorded.The improvement rate of the two groups was recorded at 3,6,9,12months.The SF-36 scale was used to evaluate the life quality of the two groups before and after treatment.Adverse reactions were recorded during treatment.Results The absorption rate,sputum negative rate and cavity closure rate of the observation group were significantly higher than those of the control group(P<0.05).The improvement rate of the observation group was significantly higher than that of the control group at 3,6,9,12,and 12 months(P<0.05).The physiology,physical pain,physiological function,overall health,social function,emotional function,vitality and mental health score of the two groups were significantly higher than those before treatment.The quality of life scores of the observation group were significantly higher than those of the control group(P<0.05).The adverse reaction rates were compared between the two groups during treatment(P>0.05).Conclusion 2HREZ(A)(LV)/4HR regimen is effective and safe for the treatment of refractory cavitary tuberculosis based on bronchoscopy-assisted perfusion.It is worthy of promotion.

关 键 词：难治性空洞型肺结核 支气管镜 局部灌注 生活质量 2HREZ(A)(LV)/4HR方案 

分 类 号：R521[医药卫生—内科学]