Therapeutic effect and program research of local chemotherapy using bronchofibroscope in treatment of tracheobronchial tuberculosis

ObjectiveTo investigate a reasonable plan of local chemotherapy using bronchofibroscope in the treatment of tracheobronchial tuberculosis.Methods The efficacy of systemic chemotherapy combined with local chemotherapy using bronchofibroscope in 255 patients with tracheobronchial tuberculosis were retrospectively analyzed.49 patients were locally injected with isoniazid,amikacin and rifampin (multi-drug group),152 patients were locally injected with isoniazid and rifampicin (two-drug group),54 patients were partially treated with rifampicin alone (single drug group).Results ①The treatment time in multi-drug group and two-drug group[ (4.3±3.9) times,(5.0 ±4.0) times]was lower than that in single drug group[(9.9 ± 5.2)times]( P <0.01 ).②After local chemotherapy using bronchofibroscope for four weeks,the endoscopic lesions in more than 50 ％ patients were reduced or disappeared,there was no statistical significance on improvement rate among three groups.③After local chemotherapy using bronchofihroscope for four weeks,lesions by chest radiograph or chest CT had different levels of absorption in three groups,but there was no statistical significance among three groups.④At the end of local chemotherapy,the total effective rates of lesion absorption by chest radiograph or chest CT were respectively 82 ％,80 ％,44 ％ in three groups.The total effective rate of lesion absorption in multi-drug group and two-drug group was higher than that in single drug group ( P <0.05).⑤At the endof local chemotherapy,the incidence of bronchial stenosis (16.3 ％) in multi-drug group was higher than that in two-drug group (4.6 ％) and single drug group (5.6 ％ )( P <0.05).Conclusions Because of less administered frequency,better efficacy,and less adverse effect,local injection of isoniazid and rifampicin bybronchofibroscope is the best local treatment of tuberculosis tracheobronchial. Key words: Tuberculosis; Tracheobronchial; Local chemotherapy; Bronchofibroscope