Geng Shujun, Li Lijuan, Liu Jianling, Song Tao
Ward 4, Department of Tuberculous Internal Medicine, Hebei Chest Hospital, Shijiazhuang, Hebei, P.R. China.
Cadre Ward 2, Bethune International Peace Hospital, Shijiazhuang, Hebei, P.R. China.
Exp Ther Med. 2016 Aug;12(2):957-960. doi: 10.3892/etm.2016.3337. Epub 2016 May 12.
The aim of the study was to compare the mid- and long-term effects of different treatments such as CT-guided percutaneous pulmonary paracentesis, tuberculoma perfusing chemotherapy and whole-body standard chemotherapy or extended chemotherapy on safety and effectiveness for pleural chemotherapy. A total of 60 subjects diagnosed to have pleural tuberculosis between February 2010 and February 2014 were prospectively selected for this study and were considered as the experimental group. Seventy pleural tuberculosis patients who underwent treatment between February 2006 and February 2010 were considered as the control group. The patients in the experimental group were treated with CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy of not more than three courses with each course consisting of administration of 0.1 g isoniazid, n 0.5 gkanamyci, 0.2 g levofloxacin, and 1 ml lidocaine once a week for four times. The patients in the control group were treated with whole-body standard or extended chemotherapy regimen 36HRZE(S)/612HR. The patients were followed up for 18 months and the treatment effects were compared. The diameter of tuberculoma in patients of the experimental group during 6, 12 and 18 months was shorter than that of the control group (P<0.05). The total effective rate of treatment and the duration of treatment in experimental group during 18 months were higher than that of control group (P<0.05). The frequency of drug-related complications were lower in comparison with the control group (P<0.05). No surgically acquired complications were observed in the experimental group. Thus, treatments such as CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy for pleural tuberculosis are safe and effective, which has greater value and can be promoted for use in the clinical setting.
本研究的目的是比较不同治疗方法,如CT引导下经皮肺穿刺、结核瘤灌注化疗以及全身标准化疗或扩大化疗,对胸膜化疗的安全性和有效性的中长期影响。前瞻性选取2010年2月至2014年2月期间诊断为胸膜结核的60例患者作为实验组。将2006年2月至2010年2月期间接受治疗的70例胸膜结核患者作为对照组。实验组患者采用CT引导下经皮肺穿刺及结核瘤灌注化疗,疗程不超过3个疗程,每个疗程每周一次给予0.1 g异烟肼、0.5 g卡那霉素、0.2 g左氧氟沙星和1 ml利多卡因,共4次。对照组患者采用全身标准或扩大化疗方案36HRZE(S)/612HR。对患者进行18个月的随访并比较治疗效果。实验组患者在6个月、12个月和18个月时结核瘤直径短于对照组(P<0.05)。实验组18个月时的治疗总有效率和治疗持续时间高于对照组(P<0.05)。与对照组相比,药物相关并发症的发生率较低(P<0.05)。实验组未观察到手术获得性并发症。因此,CT引导下经皮肺穿刺及结核瘤灌注化疗等治疗胸膜结核的方法安全有效,具有较大价值,可在临床推广应用。