论文部分内容阅读
目的:探讨门诊以3VTHPKX/15VTHPX的方案全程管理治疗耐多药肺结核病的方法、效果及不良反应。方法:肺科门诊2008年l月至2011年10月全程管理治疗的42例经药敏确诊的耐多药肺结核患者,从临床症状、治疗依从性、放射学表现、细菌学检查及不良反应等方面进行全面评估。结果:42例中有22例3月末痰菌转阴;占52%;6月末有31例痰菌转阴,占73%;9月末有37例痰菌转阴,占88%;余5例中有3例因经济困难多次停药,2例因肝损害多次停药。完成18个月疗程后其痰菌阴转率为95%;放射学完成疗程后病灶明显吸收率为81.5%,吸收率为97.3%;X线表现3月末42例中有31例病灶吸收好转,占73%;6月末有38例病灶吸收好转,占90%;疗程结速时有39例病灶吸收好转,占92%;余3例病灶略有进展。不良反应42例中有6例出现不同程度的肝损害,其中2例反复出现肝损害致多次停药。在治疗开始1月内有12例出现胃肠道反应。有2例在治疗至5月末时出现焦虑等精神症状。结论:该方法可被大多数患者所接受,副反应轻微,治疗费用低,对提高MDR-TB治愈率有促进作用。
Objective: To explore the methods, effects and adverse reactions of outpatient management of multidrug - resistant pulmonary tuberculosis with 3VTHPKX / 15VTHPX regimen. Methods: From January 2008 to October 2011, 42 patients with multi-drug resistant pulmonary tuberculosis who were managed by the department of pulmonary medicine from January 2008 to October 2011 were selected from clinical symptoms, treatment compliance, radiological findings, bacteriological examination and adverse reactions A comprehensive assessment. Results: Of the 42 cases, 22 cases were sputum negative at the end of March, accounting for 52%; 31 cases of sputum negative were negative at the end of June, accounting for 73%; 37 cases were sputum negative at the end of September, accounting for 88%; the remaining 5 cases In 3 cases due to financial difficulties repeatedly stopped, 2 cases due to multiple liver damage. After 18 months of treatment, the sputum negative conversion rate was 95%. After radiotherapy, the apparent absorption rate of the lesions was 81.5% and the absorption rate was 97.3%. The X-ray findings showed that 31 of the 42 cases were absorbed and improved at the end of March, Accounting for 73%; at the end of June, 38 cases improved the absorption of the lesion, accounting for 90%; at the time of treatment, 39 cases improved the absorption of the lesion, accounting for 92%; the other 3 cases showed slight improvement. Adverse reactions of 42 cases in 6 cases of varying degrees of liver damage, including two cases of repeated liver damage caused by multiple discontinuation. In the first month of treatment there are 12 cases of gastrointestinal reactions. There are 2 cases of psychiatric symptoms such as anxiety when they are treated till the end of May. Conclusion: This method can be accepted by most patients with minor side effects and low cost of treatment, which can promote the cure rate of MDR-TB.