Objective To explore the clinical efficacy of local bronchofiberscopic lavage and medical injections for tuberculous bronchiectasis.Methods 43 patients with tuberculous bronchiectasis received bronchofiberscopic lavage and medical injections in addition to conventional anti-infection treatment and standard antituberculosis therapy.The clinical manifestations,laboratory findings,and chest X-ray features were observed before and after the bronchofiberscopic treatment.Results After administration of general and local medications,body temperature was declined; cough,expectoration,and hemoptysis were markedly decreased; peripheral leukocyte count was lowered; and tuberculous lesions and infection lesions of bronchiectasis were obviously improved on X-ray examinations.The treatment-effective rate is 97.67％.Conclusions Local bronchofiberscopic lavage and medical injections can effectively clear intra-airway sputum bolts,smaller clots,and secretions,resulting in relief of bronchial obstruction,improvement in lung function,reduced infectivity in patients with active pulmonary tuberculosis,and an increased reversion rate of tubercule bacillus in sputum.It is a safe,rapid,effective approach for tuberculous bronchiectasis.

Objective To explore the clinical characteristics of the diagnosis and treatment of chronic obstructive pulmonary disease (COPD) concurrent with pulmonary tuberculosis.Methods The clinical data on 56 patients with COPD complicated by pulmonary tuberculois who had been treated during the period of January 2009 to October 2012 were retrospectively analyzed.Results COPD concurrent with pulmonary tuberculosis mainly occurred in elderly males (76.8％),most of whom were smokers.No distinctive symptoms,chest X-ray patterns,and laboratory test results were found.The detection rate of acid-fast bacilli in sputum was low (23.2％); and PPD test was positive in only 30.4％ of all the patients.No marked tuberculosis-ralated toxic symptoms were seen.After regular treatment,medical conditions were improved in a majority of the patients.Conclusions COPD complicated by pulmonary tuberculosis is not uncommon.Missed diagnosis and misdiagnosis are easy to occur in this condition,to which we should pay attention.Early diagnosis and regular treatment are key to achieving a better efficacy.

近10余年来,耐多药结核病(MDR-TB)的增多和流行是全球结核病控制面临的严重挑战和亟急待解决的难题.本院自2000年9月-2004年9月对94例耐多药肺结核患者应用卡介菌多糖核酸(斯奇康,BCG-PSN)与抗结核药联合治疗和单纯化疗进行了临床对比观察,现报告如下.

Objective To study the clinical significance of C-reactive protein(CRP)in evaluation of the curative effect of pulmonary tuberculosis.Method 100 cases of patients with pulmonary tuberculosis were selected,who were divided into 40 patients with smear-positive and 60 smear-negative and the variations of CRP and erythrocyte sedimentation rate(ESR)in those patients were analyzed.Results(1)No significant differences were found in the average values of CRP and ESR between the two groups(all the P values>0.05).(2)A significant difference was found in the average value of CRP(P<0.05),but no significant difference in that of ESR(P>0.05)in smear-negative group between prior treatment and post-treatment.(3)The statistical differences were not observed in the average values of CRP and ESR in smear-negative group between prior treatment and post-treatment(P>0.05).Conclusion The variations of CRP can be employed between prior-and post-antituberculosis treatment for the patients with active pulmonary tuberculosis,especially the patients with smear-positive,which is used a marker of evaluating the curative effect of antituberculosis treatment.

目的探讨广东省结核病控制项目初治涂阳肺结核治疗2月末痰涂不阴转病人的临床特点,为提高化疗效果提供参考资料.方法对项目实施初期所收治的初治涂阳肺结核治疗2月末痰涂不阴转的78病人的临床资料进行分析.结果①年龄≥60岁15例(19.2%);②合并糖尿病16例(20.5%);③平均就诊延误122天;④病灶占3个肺野以上55例(70.5%),有空洞43例(55.1%),空洞≥2厘米28例;⑤耐药16例(20.5%),其中耐多药4例;⑥治愈与完成疗程55例(70.5%).结论就诊延误时间长,结核病病情重是初治涂阳肺结核化疗2月末痰菌不阴转的主要原因,结核病防治工作需加强健康教育.

目的了解灯盏花素注射液治疗抗结核药物性肝损的疗效.方法 60例肺结核患者在抗结核治疗过程中出现抗结核药物性肝损,且达到停药标准时,随机分为2组.治疗组30例每天用灯盏花素注射液30ml加入10%的葡萄糖溶液500ml中静脉滴注,对照组30例则以维生素C 2g替代灯盏花素注射液,疗程均为25～30d,以肝功能恢复到正常为治疗有效,观察两组的有效率,用χ2检验两者的差异显著性.结果实验组治疗药物性肝损有效率83.3%,比对照组50%高(P<0.01).结论灯盏花素注射液对肝损害有保护作用,用于治疗抗结核药物性肝损是有效的.

目的：探讨肺结核患者并肺部真菌感染的临床特点、诱因、常见菌种及诊断与防治。方法：分析1999年11月～2000年11月38 例肺结核住院患者合并肺部真菌感染的临床资料。结果：38例肺结核合并真菌感染患者中，真菌感染的类型主要以白色念珠菌感染为主，其次为热带念珠菌，最后是酵母菌和曲霉菌；感染发生与患者的原发病，抗生素反复、长期使用及不合理应用，长期使用激素或其它免疫抑制剂等有着密切的关系。结论：近年本院肺结核患者合并真菌感染的情况明显，早诊断，早治疗及合理、预防用药是减少肺部真菌感染发生的关键。