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目的探讨耐多药肺结核(MDR-TB)经纤支镜介入治疗的疗效。方法147例经痰结核菌培养确定的耐多药肺结核患者随机分为2组,均采用3VDZThAK/18VDTh抗痨方案治疗,治疗组强化期同时使用纤支镜介入治疗,然后比较两组的临床疗效。结果疗程结束时,在痰菌阴转(涂片与培养)、病灶吸收总有效率、空洞闭合率方面,治疗组和对照组分别为97.2%和60%,93.1%和48%,98.7%和37.5%,75.7%和46.3%,两组比较均有显著性差异(P<0.01);治疗6个月时,治疗组发热、咳嗽、咳痰、呼吸困难消失率亦均高于对照组(P<0.01)。结论经纤支镜介入治疗联合全身化疗治疗耐多药肺结核,疗效显著优于单纯全身化疗,有促使痰菌阴转、病灶吸收、空洞闭合作用,临床症状消失率好,并且无明显不良反应,并发症少,安全可靠,值得临床推广使用。
Objective To investigate the efficacy of multidrug-resistant pulmonary tuberculosis (MDR-TB) treated with fiberoptic bronchoscopy. Methods A total of 147 patients with multidrug-resistant pulmonary tuberculosis (TB) confirmed by culture of sputum from Mycobacterium tuberculosis were randomly divided into two groups. All patients were treated with 3VDZThAK / 18VDTh anti-tuberculosis therapy. In the treatment group, bronchofibroscopic interventional therapy was used simultaneously. . Results At the end of the course of treatment, there were 97.2% and 60%, 93.1% and 48%, 98.7% and 97.7% in the treatment group and the control group respectively in the sputum negative conversion (smear and culture), the total effective rate of the lesion absorption and the void closure rate 37.5%, 75.7% and 46.3%, respectively. There was significant difference between the two groups (P <0.01). At 6 months, the disappearance rates of fever, cough, expectoration and dyspnea in the treatment group were also higher than those in the control group <0.01). Conclusion interventional therapy by fiberoptic bronchoscopy combined with systemic chemotherapy in the treatment of multidrug-resistant pulmonary tuberculosis, the curative effect is significantly better than that of systemic chemotherapy, there is to promote the sputum negative conversion, lesion absorption, empty closure, disappearance of clinical symptoms is good, and no significant adverse reactions, Less complications, safe and reliable, it is worth to promote clinical use.