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目的探讨耐多药空洞型肺结核采用CT引导经皮肺穿刺注药治疗的疗效优势。方法抽选156例已确诊为耐多药空洞型肺结核患者为临床研究,采用数字表发分为对照组(n=78例,单纯使用抗结核药物化疗)和观察组(n=78,在对照组治疗基础上联合CT引导下经皮肺穿刺注药治疗),比较两组患者的近远期疗效差异。结果治疗6个月后,观察组患者发热、咳嗽、咳痰以及胸痛等临床症状消失率明显高于对照组(P<0.05);治疗18个月后,观察组患者的痰菌转阴率75.6%、空洞闭合率48.7%以及其病灶吸收率71.8%均显著高于对照组44.9%、19.2%、41.0%(P<0.05);两组患者均无严重不良反应。结论耐多药空洞型肺结核采用CT引导经皮肺穿刺注药治疗,能明显提高近远期治疗疗效,且不增加不良反应,操作安全。
Objective To investigate the efficacy of CT-guided percutaneous pulmonary puncture in the treatment of multi-drug-resistant pulmonary tuberculosis. Methods A total of 156 patients who had been diagnosed as MDR-TB were enrolled in the study. The patients were divided into control group (n = 78) and observation group (n = 78) Group based on the combination of CT-guided percutaneous pulmonary puncture drug treatment), the two groups of patients with short-term differences in efficacy. Results After 6 months of treatment, the disappearance rate of clinical symptoms such as fever, cough, sputum and chest pain in the observation group was significantly higher than that in the control group (P <0.05). After 18 months of treatment, the sputum negative rate in the observation group was 75.6 %, Void closure rate of 48.7%, and focal lesion absorption rate of 71.8% were significantly higher than that of the control group (44.9%, 19.2%, 41.0%, P <0.05). No adverse reactions were found in both groups. Conclusion Multidrug-resistant tuberculosis pulmonary tuberculosis using CT-guided percutaneous pulmonary puncture drug injection can significantly improve the short-term treatment efficacy, and does not increase the adverse reactions, safe operation.