试验性抗结核治疗78例临床分析

Clinical Analysis of Diagnostic Antituberculotic Treatment of 78 Cases

目的 对非结核病患者使用试验性抗结核治疗总结其临床经验教训。方法 对 1992～ 1999年本科住院曾使用试验性抗结核治疗的 78例患者进行回顾性分析。结果 78例患者中 ,非结核病患者 19例。其中 5例患者可通过仔细分析病史、详细体格检查、完善辅助检查而得以确诊 ,从而避免试验性抗结核治疗。 2例患者在试验性抗结核治疗中使用了激素 ,掩盖了病情。 6例患者试验性抗结核治疗曾取得一定疗效 ,但在其后的长期随访中确诊为其它疾病。结论 试验性抗结核治疗是一项行之有效的集鉴别与治疗于一体的临床手段 ,但在试验性抗结核治疗前须完善有关检查 ,治疗中不宜盲目使用激素 ,即使治疗有效亦不应放松警惕 ,注意随访。

Objective To summary the clinical experiences and lessons on the applying of diagnostic antituberculotic treatment to non-tuberculotic patents Method 78 cases by diagnostic antituberculotic treatment during 1992 to 1999 in our department were retrospictively analysed Result In these 78 cases, 19 cases were non-tuberculotic patients Among them, 5 cases might have been diagnosed before diagnostic antituberculotic treatment by carefully analysing case histories, thoroughly physical examination, perfecting accessory examination, thus diagnostic antituberculotic treatment might have been avoided To other 2 cases, the states of illness were concealed because the use of hormen 6 cases were diagnosed as other diseases in the long term follow-up survey even though the diagnostic antituberculotic treatment seemed to be effective to some extent Conclusion Diagnostic antituberculotic treatment is an effective method in diagnosis and treatment Before treatment relative examination should be completed Hormen should not be used aimlessly during treatment Follow-up survey should not be ignored even if the treatment is effective