中国保健营养（中旬刊）
中國保健營養（中旬刊）
중국보건영양（중순간）
China Hwalth Care & nutrition
2013年
12期
31-32
,共2页
刘小燕%郑正%杨坤云%王永利
劉小燕%鄭正%楊坤雲%王永利
류소연%정정%양곤운%왕영리
肺结核%抗多种药物性%穿刺术%介入治疗
肺結覈%抗多種藥物性%穿刺術%介入治療
폐결핵%항다충약물성%천자술%개입치료
pulmonary tuberculosis%multi-drug resistant%centesis%interventional treatment
目的：探讨经纤维支气管镜气囊导管灌洗注药介入治疗耐多药空洞性肺结核的临床价值。方法：将56例耐多药空洞性肺结核患者随机分为介入治疗组(28例)和单纯化疗组(28例),均用3KmHPThZV/18PaVThZ化疗方案治疗,介入治疗组采用经纤维支气管镜气囊导管灌洗注药介入治疗,单纯化疗组单用抗结核药物治疗,观察疗效。结果：疗程结束时,介入治疗组痰菌阴转率(82.1%)、病灶吸收率(85.7%)、空洞闭合率(57.1%)明显高于单纯化疗组的46.4%、46.4%和21.4%(P<0.05)。2组完成疗程时痰菌阴转者经0.5~1年随访,实验组和对照组各分别复发1例和2例,复发率分别为3.6%和7.1%,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引导下经皮肺穿刺空洞内置中心静脉导管介入治疗耐多药空洞性肺结核具有加速痰细菌学阴转、病灶吸收和空洞闭合的作用，可促进症状改善，提高患者的生活质量。是一种有效安全的介入方法，且无明显的并发症及毒副反应,值得临床推广应用。
目的：探討經纖維支氣管鏡氣囊導管灌洗註藥介入治療耐多藥空洞性肺結覈的臨床價值。方法：將56例耐多藥空洞性肺結覈患者隨機分為介入治療組(28例)和單純化療組(28例),均用3KmHPThZV/18PaVThZ化療方案治療,介入治療組採用經纖維支氣管鏡氣囊導管灌洗註藥介入治療,單純化療組單用抗結覈藥物治療,觀察療效。結果：療程結束時,介入治療組痰菌陰轉率(82.1%)、病竈吸收率(85.7%)、空洞閉閤率(57.1%)明顯高于單純化療組的46.4%、46.4%和21.4%(P<0.05)。2組完成療程時痰菌陰轉者經0.5~1年隨訪,實驗組和對照組各分彆複髮1例和2例,複髮率分彆為3.6%和7.1%,2組複髮率比較差異無統計學意義(P>0.05)。介入治療組無嚴重不良反應。結論：CT引導下經皮肺穿刺空洞內置中心靜脈導管介入治療耐多藥空洞性肺結覈具有加速痰細菌學陰轉、病竈吸收和空洞閉閤的作用，可促進癥狀改善，提高患者的生活質量。是一種有效安全的介入方法，且無明顯的併髮癥及毒副反應,值得臨床推廣應用。
목적：탐토경섬유지기관경기낭도관관세주약개입치료내다약공동성폐결핵적림상개치。방법：장56례내다약공동성폐결핵환자수궤분위개입치료조(28례)화단순화료조(28례),균용3KmHPThZV/18PaVThZ화료방안치료,개입치료조채용경섬유지기관경기낭도관관세주약개입치료,단순화료조단용항결핵약물치료,관찰료효。결과：료정결속시,개입치료조담균음전솔(82.1%)、병조흡수솔(85.7%)、공동폐합솔(57.1%)명현고우단순화료조적46.4%、46.4%화21.4%(P<0.05)。2조완성료정시담균음전자경0.5~1년수방,실험조화대조조각분별복발1례화2례,복발솔분별위3.6%화7.1%,2조복발솔비교차이무통계학의의(P>0.05)。개입치료조무엄중불량반응。결론：CT인도하경피폐천자공동내치중심정맥도관개입치료내다약공동성폐결핵구유가속담세균학음전、병조흡수화공동폐합적작용，가촉진증상개선，제고환자적생활질량。시일충유효안전적개입방법，차무명현적병발증급독부반응,치득림상추엄응용。
Objective:To evaluate the clinical treatment value of CT-guided percutaneous lung centesis indwel ing central venous catheter administration in treatment of cavitary multi-drug resistant pulmonary. Methods:56 patients with cavitary multi-drug resistant pulmonary tuberculosis were randomized 1:1 to experimental group and control group. Al patients received chemotherapy with 3KmHPThZV/18PaVThZ Meanwhile. 28 patients in experimental group received CT-guided percutaneous lung centesis indwel ing central venous catheter administration combined with antituberculosis treatment, and 28 patients in control group received antituberculosis treatment alone. Clinical study of interventional treatment were observed. Results:At the end of the treatment, the sputum negative conversion rate was 82.1%, lesion absorption rate was 85.7%,and cavity closure rate was 57.1%in the experimental group, al of which were higher than those of the controls (46.4%,46.4%and21.4%)(P<0·05). The patients with the sputum negative conversion at the end of the treatment in two groups were fol owed up for 0.5~1 years, Experimental group and control group were 1 case and 2 cases of recurrence, the recurrence rates were 3.6%and 7.1%. There was no statistical y significant difference on recurrent rates in two groups(P>0.05). There were not severe adverse reactions observed in the experimental group. Conclusions:The interventional treatment under CT-guided percutaneous lung centesis indwel ing central venous catheter administration in treatment of cavitary multi-drug resistant pulmonary is effective in improving sputum negative conversion, lesion absorption and cavity closure. It is a reliable therapy method,and no obvious complication and adverse reaction are observed. It is to be worth to extend.
