肺结核病人治疗失败的原因分析及护理对策

The reason and nursing countermeasures of treatment failure of pulmonary tuberculosis patients

分析肺结核病人治疗失败的原因，以便施予针对性的治疗和护理。回顾性分析近5年我院治疗肺结核失败116例病人的原因，并对其采用家庭访视，查阅病历，服药登记表及登记卡随访记录等方法进行调查。116例肺结核病人治疗失败的主要原因为：对自身疾病认识不足而不规范服药50例（43．1％），合并糖尿病25例（21．55％），耐药菌感染21例（18．1％），药物反应不能服药11例（9．48％），去向不明7例（6．05％），拒绝治疗2例（1．72％）。加强肺结核病防治知识和结核病控制项目的宣传力度，做好心理护理，建立“引导一合作型”的良好护患关系，积极治疗糖尿病，提高老年病人的服药依从性，并采用直接面视下的短程化疗和家庭监督等双重护理管理模式，从而达到控制肺结核的目的，提高病人治愈率。

Objective To analyze the cause of treatment failure of pulmonary tuberculosis patients; so as to give special nursing and treatment. Methods The causes of treatment failure of 116 pulmonary tuberculosis patients were retrospectively analyzed in recent 5 years; the patients were investigated by family visit, reading medical records, taking medicine registration and checking follow - up records. Results Among 116 pulmonary tuberculosis patients, the main causes of treatment failure were： 50 cases （43. 1% ） with insufficient tmderstanding of their illness and non -compliance with anti -tuberculosis medications; 25 cases （21.55 % ） with diabetes; 21 cases （ 18. 1% ） with resistant bacterial infection; 11 cases （9.48%） no taking medicine duo to drug reaction; 7 cases （6. 05% ） leaving hospital with no further contact; 2 cases （ 1.72% ） refused the treatment. Conclusions Strengthening the propaganda work of prevention and control of tuberculosis, doing well psychological nursing, establishing good nurse patients relationship with guidance - cooperation, actively treating diabetes, improving the drug compliance of elderly patients, directly using double nursing mode of short - course chemotherapy and family observation can achieve the aim to control the pulmonary tuberculosis and improve the cure rate of the patients.