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目的探索耐多药空洞型肺结核病人CT定位下经皮肺穿刺空洞注药术的操作要点及其临床应用价值。方法临床确诊痰菌阳性耐多药的空洞型肺结核84例,在CT导向下根据自制体表定位标记带选择进针点、进针角度、进针路径行空洞内灌注给药。结果84例病人穿刺成功率100%,并发气胸3例,肺出血1例,皮下气肿1例。治疗后痰菌转阴率为91.7%,空洞好转率89.3%,空洞闭合率66.7%。结论CT引导下经皮肺穿空洞给药技术具有简单易行、直观、定位准确、并发症少等优点,对治疗痰菌阳性耐多药的空洞型肺结核具有重要的临床应用价值。
Objective To explore the operative points and clinical value of percutaneous pulmonary puncture in patients with multidrug-resistant pulmonary tuberculosis under CT location. Methods 84 cases of sputum positive multidrug-resistant pulmonary tuberculosis were diagnosed clinically. According to CT guided self-made body surface marker bands, 84 cases were selected. Results 84 cases of successful puncture rate of 100%, 3 cases of pneumothorax, pulmonary hemorrhage in 1 case, subcutaneous emphysema in 1 case. After treatment, the rate of sputum negative conversion rate was 91.7%, void improvement rate 89.3%, void closure rate 66.7%. Conclusion The CT-guided percutaneous pulmonary perforating technique has the advantages of simple, straightforward, accurate positioning and less complications. It has important clinical value in treating pulmonary tuberculosis with positive multi-sputum bacterium.