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目的探讨和评价经纤维支气管镜导管注入含药凝胶治疗耐多药结核性干酪性肺炎的临床疗效。方法从1999年3月～2005年1月共治疗9例耐多药结核干酪性肺炎,在全身应用以KOP为主的复治化疗方案的基础上,另在干酪性肺炎病变处肺段经纤维支气管镜介入导管注入含药凝胶,凝胶中每20mL中含帕司烟肼600mg,链霉素1000mg,吡嗪酰胺500mg,左氧氟沙星400mg,每次约15～20mL,一般隔周1次,共4～8次。结果9例病人经过平均4.5个月的治疗,痰菌涂片及培养均阴转,原干酪样病灶大部分吸收好转,无严重不良反应出现。结论含药凝胶介入治疗耐多药结核性干酪性肺炎是一种有效和安全的新方法。
Objective To investigate and evaluate the clinical efficacy of transdermal bronchofibers catheterized drug-containing gel in the treatment of multidrug-resistant tuberculous caseous pneumonia. Methods From March 1999 to January 2005, 9 cases of multidrug-resistant tuberculous caseous pneumonia were treated. On the basis of general KOP-based chemotherapy regimen, Bronchoscope interventional catheter into the drug-containing gel, every 20mL gel containing palmatine hydrazine 600mg, streptomycin 1000mg, pyrazinamide 500mg, levofloxacin 400mg, each about 15 ~ 20mL, usually every other week, a total of 4 to 8 times. Results Nine patients were treated with an average of 4.5 months. The smear and culture of sputum were both negative. Most of the cases of original casein absorption improved without serious adverse reactions. Conclusion Interventional drug-containing gel treatment of multidrug-resistant tuberculous caseous pneumonia is a new effective and safe method.