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中国防痨杂志 ›› 2008, Vol. 30 ›› Issue (6): 528-531.

• 论著 • 上一篇    下一篇

耐多药空洞肺结核药物凝胶局部介入治疗临床观察

陈志;梁建琴;王金河;冯士生;王卉   

  1. 解放军总医院第二附属医院全军结核病研究所 北京 100091
  • 出版日期:2008-06-10 发布日期:2011-11-03

Clinical study on treatment of multi-drug resistance cavitary pulmonary tuberculosis with drug gel

Chen Zhi,Liang Jianqin,Wang Jinhe,et al.   

  1. Tuberculosis research institute of PLA,second affiliated hospital of PLA General Hospital,Beijing 100091,China
  • Online:2008-06-10 Published:2011-11-03

摘要: 目的探讨经纤支镜结核空洞局部灌注含药凝胶治疗耐多药空洞肺结核(multiple-drug resistance tuberculosis,MDR-TB)的临床疗效。方法将经痰抗酸杆菌涂片和培养、药敏实验,影像学诊断确诊的204例耐多药空洞肺结核患者纳入观察范围,其中108例经含药凝胶结核空洞局部介入治疗患者归入凝胶组,其余96例未用含药凝胶结核空洞局部介入治疗的患者归入一般治疗的对照组。凝胶组应用纤支镜局部结核空洞灌注含药凝胶(每20ml凝胶内含帕司烟肼600mg、链霉素1000mg、吡嗪酰胺500 mg、左旋氧氟沙星400 mg)治疗和全身抗结核药物治疗,对照组用全身抗结核药物治疗。检测2组患者治疗后6、12和18个月的痰菌阴转率、结核病灶治疗有效率、结核空洞治疗有效率、并发症及不良反应。结果凝胶组治疗后6、12和18个月痰菌阴转率为51.9%、79.6%和88.9%,显著高于对照组;凝胶组结核病灶治疗有效率为52.8%、81.5%和90.7%,结核空洞治疗有效率为50.9%、79.6%和89.8%,显著高于对照组。2组并发症及不良反应发生率差异无统计学意义。结论经纤支镜含药凝胶结核空洞局部介入治疗可以提高耐多药空洞肺结核,不良反应小、安全有效。

关键词: 结核, 凝胶, 多种药物性

Abstract: Objective To evaluate the clinical outcome and safety of the treatment of multi-drug resistance cavitary pulmonary tuberculosis with drug gel by fiberbronchoscope.Methods 204 patients of cavitary pulmonary tuberculosis were included in the study.108 patients of them treated with drug gel by fiberbronchoscope and anti-tuberculosis treatment were classified into the experiment group.96 patients treated anti-tuberculosis treatment were classified into the control group.20 mg of the gel used in the experiment group contains pasiniazid 600 mg,streptomycin 1000mg,pyrazinamide 500mg and L-ofloxacin 400mg.Sputum negative conversion rate,tuberculose focus treatment effective power,tuberculous cavity treatment effective power,complication and adverse reaction of all patients at the 6th,12th and 18th month post-treatment were observed.Results Sputum negative conversion rate in the experiment group were 51.9%,79.6% and 88.9% at the 6th,12th and 18th month post-treatment respectively,which were higher than those in the control group.Tuberculose focus treatment effective power in the experiment group were 52.8%,81.5% and 90.7%,tuberculous cavity treatment effective power were 50.9%,79.6% and 89.8% at the 6th,12th and 18th month post-treatment respectively,which were higher than those in the control group too.Complication and adverse reaction of patients in the two groups had no significant difference.Conclusions The clinical outcome and safety of the treatment of multi-drug resistance cavitary pulmonary tuberculosis with drug gel by fiberbronchoscope are better than those of the routine anti-tuberculosis treatment.

Key words: tuberculosis, gel, multi-drug resistance