复治菌阳肺结核个体化治疗及疗效评估  

Individual treatment and efficacy evaluation of retreated bacterial positive pulmonary tuberculosis

作　　者：李翼 丁菡 LI Yi;DING Han(No.2 Department of Tuberculosis,Wuhan Jinyintan Hospital,Wuhan 430000,China)

机构地区：[1]武汉市金银潭医院结核2科,湖北武汉430000 [2]武汉市金银潭医院结核5科,湖北武汉430000

出　　处：《创伤与急危重病医学》2020年第3期194-196,共3页Trauma and Critical Care Medicine

摘　　要：目的探讨复治菌阳肺结核患者实施个体化治疗的临床疗效,旨在为临床用药提供参考。方法选取自2013年2月至2018年2月武汉市金银潭医院收治的83例复治菌阳肺结核患者为研究对象,分为常规组(n=42)及观察组(n=41)。常规组应用标准复治方案治疗,观察组根据患者的基本资料及药敏试验结果等实施个体化治疗。比较两组患者的临床疗效、痰菌转阴率、肺部病灶改善情况及不良反应。结果治疗9个月后,观察组患者的治疗总有效率[92.7%(38/41)]显著高于常规组[73.8%(31/42)],不良反应发生率[14.6%(6/41)]显著低于常规组[33.3%(14/42)],病灶明显吸收(病灶较治疗前吸收面积≥25%)的患者比例[90.2%(37/41)]显著高于常规组[69.0%(29/42)],差异均有统计学意义(P<0.05)。治疗3、6、9个月,观察组患者的痰菌转阴率均高于常规组患者,差异有统计学意义(P<0.05)。结论个体化治疗复治菌阳肺结核患者临床效果显著,可提高痰菌转阴率、促进病灶吸收,减少不良反应。Objective To investigate the clinical effect of individualized treatment for patients with retreated bacterial positive pulmonary tuberculosis.Methods A retrospective study was performed on 83 cases of patients with retreated bacterial positive pulmonary tuberculosis who were admitted from February 2013 to February 2018.Patients were divided into the conventional group(n=42)and the observation group(n=41).The conventional group was treated with standard retreatment regimens,and the observation group was given individualized treatment according to patients′basic data and drug sensitivity test results.Clinical efficacy,sputum negative conversion rate,improvement of pulmonary lesions and adverse reactions were compared between the two groups.Results After 9 months of treatment,the total effective rate of patients in the observation group[92.7%(38/41)]was significantly higher than that of conventional group[73.8%(31/42)],adverse reactions[14.6%(6/41)]was significantly lower than that of conventional group[33.3%(14/42)],lesions obvious absorption(lesions absorbing area was 25%or higher),the proportion of patients[90.2%(37/41)]was significantly more than the conventional group[69.0%(29/42)],and the difference had statistical significance(P<0.05).After treatment for 3,6 and 9 months,the sputum negative conversion rate of the observation group was higher than that of the conventional group(P<0.05).Conclusion Individualized treatment of patients with retreatment of positive pulmonary tuberculosis has a significant clinical effect,which can improve the negative conversion rate of sputum bacteria,promote the absorption of lesions,and reduce adverse reactions.

关 键 词：复治菌阳肺结核 个体化治疗 疗效 痰菌转阴率 不良反应 

分 类 号：R521[医药卫生—内科学]