关键词: 结核, 支气管/药物疗法, 支气管镜, 输注, 病灶内

Abstract: 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 (χ²=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 (χ²=7.828，P<0.05; χ²=4.309, P<0.05 andχ²=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.

Key words: Tuberculosis, bronchi/drug therapy, Bronchoscopes, Infusions, intralesional