耐多药肺结核患者住院与门诊治疗对疗效的影响  

Effects of inpatient and outpatient treatments on patients with multidrug-resistant tuberculosis

作　　者：覃红娟[1] 谭守勇[1] 邝浩斌[1] 李艳[1] 吴桂峰[1] 徐琦[1] 张宇青[1] 

机构地区：[1]广州市胸科医院,呼吸疾病国家重点实验室,510095

出　　处：《实用医学杂志》2013年第23期3811-3814,共4页The Journal of Practical Medicine

基　　金：第五轮中国全球基金结核病项目;国家"十二五"重大科研项目(编号:2012ZX100004903-001-002)

摘　　要：目的:探讨耐多药肺结核(MDR-TB)患者治疗初期住院与门诊治疗对疗效的影响。方法:对2008年9月至2011年2月广州市采用第五轮中国全球基金结核病项目治疗方案进行诊断和治疗的88例MDR-TB患者疗效和治疗依从性进行回顾性分析。根据患者治疗初期是否住院分为住院组51例及门诊组37例。结果:(1)在88例患者中,治愈40例(45.5%),失败22例(25.0%),死亡10例(11.4%),丢失16例(18.2%)。(2)24个月末痰菌阴转率住院组[54.9%(28/51)]明显高于门诊组[32.4%(12/37)](χ2=4.367,P=0.037)。(3)住院治疗丢失率(9.8%)明显低于门诊组(29.7%)(χ2=5.723,P=0.017)。⑷在完成疗程患者中,住院组和门诊组6个月末和24个月末痰菌阴转率分别为52.4%、66.7%和50.0%、60.0%(χ2=0.013,P=0.900)。结论:对MDR-TB患者采用住院治疗和门诊治疗相结合管理模式可提高患者的治疗依从性与临床治愈率。Objective To explore the effects of inpatient and outpatient treatments on patients with muhidrug- resistant tuberculosis （MDR-TB） who were at the beginning of treatment. Methods Efficacy and compliance of 88 patients with MDR-TB, who were diagnosed and treated according to the fifth round of China Global Fund MDR-TB project in Guangzhou from Sep 2008 to Feb 2011, were retrospectively analyzed. According to whether the patients were hospitalized or not at the beginning of treatment, these patients were divided into inpatient group （n = 51 ） and outpatient group （n = 37）. Results In 88 cases, 40 cases （45.5%） were cured; treatment failure occurred in 22 cases （25.0%）, 10 （11.4%） cases died and 16 （18.2%） cases were lost. The sputum negative conversion rate at the end of 24 months of treatment in inpatient group was 54.9% （28/51）, which was significantly higher than that in outpatient group （32.4%, 12/37） （X2 = 4.367, P = 0.037）. The lost rate in inpatient group was 9.8%, which was significantly lower than that in outpatient group （29.7%） （X2 = 5.723, P = 0.017）. The sputum negative conversion rates at the end of 6 months and 24 months of treatment in inpatient group and outpatient group were 52.4%, 66.7% and 50.0%, 60.0%, respectively （X2- 0.013, P = 0.900）. Conclusion For patients with MDR-TB, the combination management of hospitalization and outpatient treatment could improve patient＇s compliance and clinical cure rate.

关 键 词：结核 肺 耐多药 住院治疗 门诊治疗 管理 

分 类 号：R521[医药卫生—内科学]