【作者】 陈南山； 董璇； 张茜；

【Author】 CHEN Nan - shan, DONG Xuan, ZHANG Qian ( Room of Fiberbronchoscope, Wuhan Tuberculosis Hospital, Wuhan, Hubei 430083 , P. R. China )

【机构】 湖北省武汉市肺科医院纤维支气管镜室；

【摘要】 目的探讨介入治疗对糖尿病并初治菌阳空洞肺结核的近、远期疗效。方法将糖尿病并初治菌阳空洞肺结核患者随机分成研究组(简称A组)及对照组(简称B组)。介入治疗方法为在电透下经纤支镜灌注含IHH、RFP、PZA的复合剂溶液5-20 mL,每周1次,每1病例介入治疗4-8次。督导化疗采用2HRZS(E)/4HR方案。结果督导化疗6个月时A组及B组的痰菌阴转率分别为96.92%、80.00%(P<0.01),空洞闭合率分别为67.69%、20.00%(P<0.01),血糖检测正常率分别为84.61%、66.15%(0.01<P<0.05);随访2 a时A组及B组的痰菌复发率分别为1.64%、18.00%(P<0.01),血糖检测正常率分别为72.13%、68.00%(P>0.05)。结论介入治疗对糖尿病并初治菌阳空洞肺结核的治疗安全有效,近、远期疗效确切,痰菌复阳率低,血糖控制理想。更多还原

【Abstract】 [ Objective] To analyze the short - term results and long - term results of diabetic tuberculosis patients presented with new bacteriological postive and cavity in pulmonary by intervention therapy. [Methods] 130 diabetic tuberculesis patients presented with new bacteriological postive and cavity in pulmonary were divided into intervention therapy group (for short group A) and control group (for short group B) by random. Cavity in pulmonary of intervention therapy group was infused the mixed liquid with INH RFP and PZA 5-20 mL one week by ra-diophotograpy when patients was treated by fiberoptic bronchoscopy. The experiment group had been treated with intervention therapy for 4-8 weeks. All cases were treated with the regimen of 2 HRZS(E)/10 HR. [Results] The splum negative conversion rate in group A and group B was 96. 92% , 80. 00% respectively (P <0. 01) , cavity closure rate in two groups was 67. 69% , 20. 00% respectively (P <0. 01 ) , blood sugar normality rate in group A and group B was 84. 61% , 66. 15% , respectively (0.01 <P<0.05). After investigation for two years, bacteriological relapse rate in group A and group B was 1.64% , 18. 00% , respectively (P <0. 01 ) , blood sugar normality rate in group A and group B was 72. 13% , 68. 00% , respectively (P >0. 05). [Conclusions] Inteventien therapy is a effective safe treatment for diabet - ic tuberculosis patients presented with new bacteriological positive and cavity in pulmonary in long - term and short - term. This treatment plays a important role in reducing long -term relapse rate and is effctive for controling blood sugar.更多还原