超声电导仪药物透入对复治肺结核患者疗效及肺功能的影响

张焕; 王勇; 王显雷; 刘会; 石璐; 刘锐

doi:10.7619/jcmp.20222949

超声电导仪药物透入对复治肺结核患者疗效及肺功能的影响

Effects of drug penetration by ultrasound conductance instrument on curative efficacy and lung function of retreated pulmonary tuberculosis patients

摘要

摘要:
目的探讨超声电导仪药物透入对复治肺结核患者疗效及肺功能的影响。
方法回顾性分析106例复治肺结核患者的临床资料，根据治疗方法不同分为2组，观察组53例进行超声电导仪药物透入治疗，对照组53例进行常规抗结核药物治疗。比较不同时点痰菌转阴率、空洞闭合率、呼吸功能、肺功能峰值呼气流速(PEF)、第1秒用力呼气容积(FEV₁)、用力肺活量占预计值百分比(FVC%)、第1秒用力呼气容积与用力肺活量的比值(FEV₁/FVC)以及并发症发生率。
结果观察组治疗后1、3、6个月的痰菌转阴率分别为67.92%、79.25%、92.45%，高于对照组的47.17%、58.49%、73.58%，差异有统计学意义(P < 0.05)。观察组治疗后1、6个月的空洞总闭合率分别为67.92%、88.68%，高于对照组的47.17%、69.81%，差异有统计学意义(P < 0.05)。治疗后1、6个月，PEF、FEV₁/FVC、FEV₁%、FVC%均较治疗前升高，差异有统计学意义(P < 0.05)；观察组治疗后1、6个月的PEF、FEV₁/FVC、FEV₁%、FVC%均高于对照组，差异有统计学意义(P < 0.05)。观察组治疗后6个月动脉血二氧化碳分压低于对照组，动脉血氧分压高于对照组，差异有统计学意义(P < 0.05)。观察组4例(7.55%)局部出现水泡、皮肤红肿，1例(1.89%)发生胃肠道反应，2例(3.77%)发生肝损伤，1例(1.89%)粒细胞减少，总并发症发生率为15.09%(8/53)。对照组3例(5.66%)出现胃肠道反应，1例(1.89%)出现神经系统症状，1例(1.89%)粒细胞减少，2例(3.77%)肝损伤，总并发症发生率为13.21%(7/53)。2组并发症发生率比较，差异无统计学意义(P=0.780)。
结论对复治肺结核患者实施超声电导仪药物透入治疗效果显著，可提高痰菌转阴率，改善肺功能。

Abstract:
Objective To explore the effect of drug penetration by ultrasound conductance instrument on the curative effect and pulmonary function of retreated pulmonary tuberculosis patients.
Methods Retrospective analysis was performed on clinical data of 106 retreated pulmonary tuberculosis patients. They were divided into two groups according to differed the treatment method. A total of 53 patients in the observation group were treated with drug penetration by ultrasonic conductance device, and 53 patients in the control group were treated with conventional antituberculosis drugs. The sputum negative conversion rate, cavity closure rate, respiratory function, pulmonary functionpeak expiratory flow rate (PEF), forced expiratory volume in the first second (FEV₁), percentage of forced vital capacity for predicted value (FVC%), ratio of forced expiratory volume in the first second to forced vital capacity (FEV₁/FVC) and complication rate in each time point were compared.
Results The sputum negative conversion rates in the observation group were 67.92%, 79.25% and 92.45% after 1 month, 3 and 6 months, respectively, which were higher than 47.17%, 58.49% and 73.58% in the control group (P < 0.05). The total cavity closure rates in the observation group were 67.92% and 88.68%, respectively at 1 month and 6months after treatment, which were higher than 47.17% and 69.81% in the control group (P < 0.05). At 1 month and 6 months after treatment, PEF, FEV₁/FVC, FEV₁% and FVC% were higher than before treatment (P < 0.05). PEF, FEV₁/FVC, FEV₁% and FVC% in the observation group were higher than those in the control group at 1 month and 6 months after treatment (P < 0.05). At 6 months after treatment, the carbon dioxide fraction of the observation group was lower than that of the control group, and the partial oxygen pressure of arterial blood was higher than that of the control group (P < 0.05). In the observation group, 4 cases (7.55%) had local blisters and skin redness, 1 case (1.89%) had gastrointestinal reaction, 2 cases (3.77%) had liver injury, and 1 case (1.89%) had granulocytopenia. The total complication rate was 15.09%(8/53). In the control group, 3 cases (5.66%) had gastrointestinal reactions, 1 case (1.89%) had neurological symptoms, 1 case (1.89%) had granulocytopenia, and 2 cases (3.77%) had liver injury. The total complication rate was 13.21%(7/53). There was no significant difference in the incidence of complications between the two groups (P=0.780).
Conclusion The treatment effect of drug penetration with ultrasonic conductance instrument for retreated pulmonary tuberculosis patients is significant, which can improve the sputum negative conversion rate and pulmonary function.

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