摘要
目的 探讨经支气管镜局部灌注抗结核药物联合全身化疗对气管支气管结核的临床疗效及应用价值.方法 对62例确诊的气管支气管结核患者,采用随机数表法分为两组,即经支气管镜局部灌注药物联合化疗组（简称“联合治疗组”）31例和单纯化疗组31例,比较两组患者在治疗2个月后的临床表现、胸部CT检查情况、抗酸杆菌阴转率,以及不同镜下类型气管支气管结核治疗转归的差异.结果 治疗2个月后,联合治疗组支气管镜下病变好转的总有效率（87.10％,27/31）高于单纯化疗组（45.16％,14/31）（x2=12.17,P＜0.01）,临床症状改善总有效率（87.10％,27/31）高于单纯化疗组（54.84％,17/31）（x2=7.828,P＜0.05）,镜下刷检找抗酸杆菌阴转率（87.10％,27/31）高于单纯化疗组（64.52％,20/31）（x2=4.309,P＜0.05）,胸部CT检查总有效率（82.14％,23/28）高于单纯化疗组（57.69％,15/26）（x2=3.865,P＜0.05）.结论 局部抗结核药物灌注联合全身化疗能缓解气管支气管结核患者的症状,促进病灶吸收,临床疗效优于单纯全身化疗.
Objective To explore the clinical efficacy and value of the local infusion of anti-tuberculosis （TB） drugs by bronchoscopy combined with anti-TB chemotherapy in the treatment of tracheobronchial TB.Methods Sixty-two patients with tracheobronchial TB were enrolled in this study and randomly divided into two groups by using the method of random number table：the ＂combined treatment group＂,in which the patients received both local infusion and chemotherapy of anti-TB drugs; and the ＂simple chemotherapy group＂ or ＂control group＂,in which patients received chemotherapy only.The sample size in each group was 31.The treatment outcomes of the patients were evaluated at the end of 2 months of treatment,including clinical manifestation,features of chest CT,conversion of acid fast bacilli （AFB） smear examination and features under bronchoscope.The results were compared between two groups.Results At the end of 2 months of treatment,the proportion of patients in the combined treatment group who had improvement of lesions under bronchoscope was 87.10％ （27/31）,which was higher than that in the simple chemotherapy group （45.16％,14/31） ; there was a statistically significant difference between the two groups （x2 =12.17,P＜ 0.01）.The proportions of clinical manifestation improvement,AFB smear conversion and chest CT improvement among patients in the combined treatment group were all significantly higher than those in the control group （x2 =7.828,P＜0.05; x2=4.309,P＜0.05 and x2 =3.865,P＜0.05）.Conclusion The local infusion of anti-TB drugs by bronchoscopy combined with systemic chemotherapy is an effective method for treatment of bronchial TB,which can rapidly relieve patient＇ s symptoms,accelerate absorption of the lesion and make better overall treatment outcomes for the patients than simple chemotherapy.
出处
《中国防痨杂志》
CAS
2014年第6期494-497,共4页
Chinese Journal of Antituberculosis
基金
温州市科技局重点课题（Y200800852）
关键词
结核
支气管/药物疗法
支气管镜
输注
病灶内
Tuberculosis,bronchi/drug therapy
Bronchoscopes
Infusions, intralesional
