肺结核化疗中病情恶化的原因回顾性分析

Retrospective analysis of exacerbation in patients with pulmonary tuberculosis during chemotherapy

目的 了解肺结核化疗期间病情恶化的原因、性质 ,探讨其处理和预防措施。方法 对 87例肺结核化疗中病情恶化患者的临床资料分时间段进行分析 ,并结合文献复习。结果 87例肺结核患者化疗中病情恶化的原因 :化疗无力 1 2例 ,感染耐药结核菌 31例 ,感染其他分支杆菌 3例 ,发生变态反应 7例 ,出现合并症 34例。近 5年 ,耐药菌的增多和合并症的出现是病情恶化的主要原因。结论 肺结核化疗期间病情恶化的原因较多 ,且随时间变迁而有所变化 ,临床需在积极抗结核的前提下 。

Objective To understand the causes for and property of exacerbation of patients with TB during chemotherapy. And to explore management and prevention of such condition.Methods We analysed the clinical data on exacerbation in 87 cases of pulmonary TB on chemotherapy by different time sections. And some related relevant literature was reviewed.Results The causes for exacerbation in these cases were classified as follows:no respond to chemotherapy in 12 patients; infection of drug resistant tubercle bacillus in 31 patients; infection of other mycobacterium in 3 cases; ocurrence of allergic reaction to 7 patients; and complications noted in 34 patients. Over the last 5 years increase of drug-resistant tubercle bacillus and ocurrence of complications have become the main causes for exacerbation of patients with TB on chemotherapy.Conclusion There are various causes resulting in exacerbation of patients with pulmonary tuberculosis during chemotherapy. And the causes may vary as time developes. The treatment of such a condition should be tailored to the specific cause on the condition that active anti-tubercle bacillus treatment is ensured.