初、复治排菌肺结核门诊短程化疗疗效分析

The Effects of Short-term Chemotherapy in Original-cure and Re-cure Patients with Pulmonary Tuberculosis

对208例初治、155例复治排菌病人,进行了短程化疗疗效观察。病变广泛伴空洞者实行9个月方案,不伴空洞者实行6个月方案。初治组行6个月方案者150例,9个月方案者58例;复治组行6个月方案者62例,9个月方案者93例。6个月方案的用药:2 S(E)RHZ/4 RH;9个月方案用药2 S(E)RHZ/7 RH。结果:(一)初治痰菌阴转206例占99%,复治阴转139例(89.68%),初、复治组P<0.001。(二)空洞闭合率:初治组57/58例为98.28%,复治组43/56为76.79%,P<0.001。(三)远期观察:1.痰菌复阳:初治组4例,复发率1.9%,复治组痰菌复阳7例(4.5%),两组无显著性差别(P>0.05)。2.满疗程后痰仍阳性者,经继续化疗1年,初治组2例中1例痰菌阴转(50%);复治组16例中5例痰阴转(31.25%)。综上,短程化疗对复治肺结核排菌病人也是可取的。

The curative effect of short-term chemotherapy in 208 original-cure patients(OCP)and 155 re-cure patients(RCP)with pulmonary tuberculosis were observed.Fifty-eightpatients in OCP and ninety-three patients in RCP with wide lesions or/and accompa-ning cavity were carried out in nine-months scheme,the others(including both OCPand RCP)were carried out in six-months scheme.The antituberculotics in OCP were2S(E)RHZ/4RH and 2S(E)RHZ/7RH in RCP.Therapeutical results:1.sputum examina-tion for tubercle bacillus(SETB)converted into negative in 206 patients(99%)in OCP,and 139 patients(89.68%)in RCP(P<0.001).2.Cavity closure ratewas 98.28% in OCP and 76.79% in RCP (P<0.001).3.Recurrence rate was 1.9% inOCP and 4.5% in RCP(P>0.05).While 1 patient(50%.1/2)in OCR and 5 patients(31.25%,5/16)in RCP whom the SETB maintained continually positive after short-term chemotherapy,they had a negative result when they had received a second termantituberculotics therapy for one year.The results showed that short-term chemotherapywould be desirable for both OCP and RCP.