黄健 韩伟 崔秀琴

摘 要 目的：探讨超声电导靶位透药治疗复治肺结核的疗效。方法：选取复治肺结核患者64例分为透药组和对照组各32例。对照组采用2HRZES/6HRE化疗方案常规治疗，透药组采用超声电导靶位透药技术治疗。比较两组的治疗效果。结果：治疗2个月后，透药组临床症状改善率、痰菌阴转率、病灶治疗有效率、空洞闭合率均高于对照组；治疗5个月后，透药组痰菌阴转率、空洞闭合率高于对照组（P<0.05）。治疗8个月后，透药组临床症状改善率、痰菌阴转率、病灶治疗有效率、空洞闭合率、临床治疗总有效率与对照组比较，差异无统计学意义；两组不良反应发生率差异无统计学意义（P>0.05）。结论：超声电导靶位透药治疗复治肺结核在短期内疗效显著，安全性高。

关键词 复治肺结核 超声电导仪 药物透入治疗

中图分类号：R459.9； R521 文献标志码：B 文章编号：1006-1533（2021）07-0048-03

Observation of curative effect of ultrasonic conductivity-targeted permeation technology in the retreatment of pulmonary tuberculosis

HUANG Jian， HAN Wei， CUI Xiuqin*

（the First Hospital affiliated to Xinxiang Medical College， Henan Xinxiang 453100， China）

ABSTRACT Objective： To investigate the effect of ultrasonic conductivity-targeted transmedication in the retreatment of tuberculosis. Methods： The patients with pulmonary tuberculosis were selected and divided into a drug-permeable group and a control group with 32 cases each. The control group was conventionally treated with 2HRZES/6HRE chemotherapy regimen while the drug permeation group with ultrasound conduction target permeation technology. The treatment effects were compared between the two groups. Results： The clinical symptom improvement rate， the sputum bacterium negative conversion rate， the effective rate of lesion treatment and the closure rate at the end of 2 months of treatment and the sputum bacterium negative conversion rate and the cavity closure rate at the end of 5 months of treatment were higher in the drug-permeable group than the control group （P<0.05）. However， the clinical symptom improvement rate， the sputum bacterium negative conversion rate， the effective rate of lesion treatment and the closure rate at the end of 8 months of treatment showed no statistical differences between the two groups （P>0.05）. Conclusion： Ultrasound conductance-targeted drug penetration therapy for the retreatment of pulmonary tuberculosis is effective and safe in the short term.

KEy WORDS retreatment of tuberculosis； ultrasound conductivity meter； drug penetration therapy

2000年—2017年全球結核病新增患者年均下降3%，但结核病仍是全球最致命的传染病[1]，复治肺结核患者数量有所增加[2]。相对于初治肺结核，复治肺结核的排菌能力更强，病程更长，治疗时间长，并且治疗难度更大。不同方案治疗复治肺结核的治疗效果有一定的差异[3]，超声电导靶位透药治疗是应用低频超声的空化作用提高组织对药物的通透性，实现药物在局部病灶的富集，以达到增效的作用[4-5]。

1 资料与方法

1.1 一般资料

选取2018年3月—2019年3月新乡医学院第一附属医院收治的复治肺结核患者64例。按随机数字表法分为对照组和透药组各32例。透药组男20例，女12例；年龄18～60岁的27例，>60岁的5例；病变范围在4个肺野内的29例；空洞数量：单个空洞者22例，多个空洞者10例；临床症状：咳嗽、咳痰28例，胸闷10例，发热25例，乏力、盗汗17例。对照组男22例，女10例；年龄18～60岁的26例，>60岁的6例；病变……