两种管理方式对复治涂阳肺结核转归的影响

Effects of 2 management modes on therapeutic outcomes of retreatment smear positive pulmonary tuberculosis patients

目的探讨两种管理方式对复治涂阳肺结核患者转归的影响。方法将56例完成9个月治疗的流动人口肺结核患者采用强化期督导方式,并按1∶1病例配对,选取56例当地户籍肺结核患者采用全程督导方式,分析影响转归的相关因素。结果复治涂阳病例总治愈率为74.1%(80/112),全程督导组(当地户籍)治愈率为83.9%(43/56),强化督导组(流动人口)治愈率为64.3%(36/56),全程督导高于强化督导组,差异有统计学意义(χ2=5.63,P<0.05)。全程督导组中不规则服药率7.14%(4/56),强化督导组为25.00%(14/56),差异有统计学意义(χ2=6.62,P<0.05);耐药患者中,全程和强化督导两组的耐药率分别为21.43%(12/56)和28.57%(16/56),差异无统计学意义(P>0.05)。结论复治涂阳肺结核患者转归受多种因素影响,其中不规则服药和耐药为主要因素,可采用全程督导管理方式提高治愈率。

Objective To investigate effect of 2 management modes on therapeutic outcomes of retreatment smear positive pulmonary tuberculosis patients. Method A total of 56 patients completed the 9-month treatment of tuberculosis among floating population under enforced supervision mode were paired with 56 local tuberculosis patients under full supervision mode in a 1 ： 1 manner. Relevant factors affecting the therapeutic outcomes were analyzed. Results Overall cure rate was 74.1% （80/ 112） for retreatment smear positive patients. The cure rate for full supervision group （local patients） and enforced supervision group （floating population） was 83.9% （43/56）and 64.3% （36/56）, respectively. The cure rate of full supervision group was higher than that of enforced supervision group, with significant difference（x^2 = 5.63,P〈0. 05）. The patients＇ irregular medication rate of full supervision group and enforced supervision group was 7. 14 % （4/56）and 25.00 % （14/56）, respectively, with significant difference（x^2 = 6.62, P〈0.05）. Drug resistant patients accounted for 21.43 % （12/56） and 28. 57 % （16/56） in full supervision group and enforced supervision group, respectively, no significant difference was observed（P〉0. 05）. Conclusion Therapeutic outcomes of retreatment smear positive tuberculosis patients were affected by many factors; irregular medication and drug resistance were major influencing factors. Full supervision management can be used to improve the cure rate.