纤维支气管镜局部给药配合全身化疗对耐多药肺结核病的治疗效果评估  

Evaluation of therapeutic effect of bronchoscopy topical administration combined with systemic chemotherapy in multi-drug resistant pulmonary tuberculosis

作　　者：李丹[1] LI Dan(Tuberculosis Control Department,Jinzhou Center for Disease Control and Prevention,Jinzhou 121000,China)

机构地区：[1]辽宁省锦州市疾病预防控制中心结核病防治科,121000

出　　处：《中国实用医药》2021年第23期44-46,共3页China Practical Medicine

摘　　要：目的分析纤维支气管镜局部给药配合全身化疗对耐多药肺结核病的治疗效果,为临床治疗提供参考。方法96例耐多药肺结核病患者,随机分为观察组和对照组,各48例。两组患者均采取全身化疗,观察组患者在全身化疗基础上采取纤维支气管镜局部给药。比较两组治疗3、6、9个月痰菌转阴情况;治疗9个月后临床症状消失情况;治疗3、6、9个月病灶吸收和空洞闭合缩小情况。结果观察组患者治疗3、6、9个月痰菌转阴率分别为64.6%(31/48)、81.3%(39/48)、87.5%(42/48),均显著高于对照组的33.3%(16/48)、52.1%(25/48)、58.3%(28/48),差异具有统计学意义(P<0.05)。观察组患者治疗9个月后发热、咳嗽、咳痰、胸痛、呼吸困难症状消失率均显著高于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗3、6、9个月病灶吸收率和空洞闭合缩小率均显著高于对照组,差异具有统计学意义(P<0.05)。结论耐多药肺结核病采取纤维支气管镜局部给药配合全身化疗效果明确,安全性高,具有使用价值。Objective To analyze the therapeutic effect of bronchoscopy topical administration combined with systemic chemotherapy in multi-drug resistant pulmonary tuberculosis,so as to provide reference for clinical treatment.Methods A total of 96 patients with multi-drug resistant pulmonary tuberculosis were randomly divided into observation group and control group,with 48 cases in each group.Both groups were treated with systemic chemotherapy,and patients in the observation group were treated with bronchoscopy topical administration on the basis of systemic chemotherapy.The negative-converstion of sputum bacteria after 3,6 and 9 months of treatment,disappearance of clinical symptoms after 9 months of treatment,lesions absorption and closure and shrinkage of cavities after 3,6 and 9 months of treatment were compared between the two groups.Results The negative-converstion of sputum bacteria of the observation group after 3,6 and 9 months of treatment were 64.6%(31/48),81.3%(39/48))and 87.5%(42/48),which were significantly higher than 33.3%(16/48),52.1%(25/48)and 58.3%(28/48)of the control group,and the difference was statistically significant(P<0.05).The disappearance rates of fever,cough,expectoration,chest pain and dyspnea of the observation group after 9 months of treatment were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).The closure and shrinkage of cavities of the observation group after 3,6 and 9 months of treatment were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of bronchoscopy topical administration and systemic chemotherapy has certain effect on the treatment of multi-drug resistant pulmonary tuberculosis with high safety,and it contains application value.

关 键 词：耐多药肺结核病 全身化疗 纤维支气管镜 局部给药 

分 类 号：R521[医药卫生—内科学]