378例涂阳肺结核临床疗效分析

Clinical analysis of 378 cases of smear-positive tuberculosis

目的了解结核病短程化疗全程间歇疗法临床疗效,分析治疗失败原因并寻求解决办法。方法初治涂阳肺结核化疗方案2H3R3Z3E3/4H3R3;复治涂阳肺结核化疗方案:2S3H3R3Z3E3/6H3R3E3。使用板式抗结核组合药,门诊医师指导下不住院家庭督导化疗。结果治疗涂阳肺结核378例,平均治愈率83.6%,初治涂阳治愈率87.3%,治疗成功率87.62%,复治涂阳治愈率67.61%。结论初治涂阳治愈率达到国家结核病控制项目要求(≥85%),治疗失败以肺结核空洞者为主(75%),对初治涂阳无空洞病例宜选择2H3R3Z3E3/4H3R3方案,初治涂阳空洞病例宜选择2S(E)HRZ/4HR或2S(E)HRZ/4HRE方案。

To understand the clinical efficacy of TB therapy short course intermittent chemotherapy and to analyze the reasons for the treatment failure while searching for its solutions. Methods The cases were given initital smear positive tuberculosis chemotherapy 2H3R3Z3E3/4H3R3 , and with the retreatment of 2S3H3R3Z3E3/6H3R3E3 smear positive tuberculosis chemotherapy. Plate-type combined anti-tuberculosis drugs were adopted to treat the disease at home under the guidance of out-patient physicians. Results Among 378 cases, the average cure rate reached 83.6%, with 87.3% cure rate for the new smear-positive treatment and 87.62% for the success rate. Retreatment smear positive cure rate reached 67. 61%. Conclusion Initial cure rate of the new smear positive tuberculosis meets the national requirements in tuberculosis control project （ ~〉85% ）. Most TB treatment failure patients have lung cavity （75%）. The program 2H3 R3 Z3 E3/4H3 R3 is preferred to those who have no lung cavity but failed in initital treatment. For those who have lung cavity and smear-positve, 2S （E） HRZ/4HR or 2S （E） HRZ/4HRE programs should be adopted.