PICC在耐多药肺结核强化期治疗中的应用效果

Application effect of PICC on intensive phase treatment of the patients with multi-drug resistant pulmonary tuberculosis

目的：探讨应用PICC对耐多药肺结核患者强化期规范治疗完成情况的影响。方法选择2010年1月至2013年1月确诊为耐多药肺结核患者64例,同时给予患者和家属进行个体化健康教育后,同意应用PICC输液治疗者32例作为观察组,不接受PICC者32例作为对照组。采用生活质量评价量表SF-36,于静脉用药治疗前和静脉用药1个月后评价两组患者生活质量的差异。采用自制量表观察不同的输液途径对患者静脉用药1个月、6个月、9个月时依从性和规范治疗完成率的影响。结果两组患者治疗前生活质量各维度得分比较,差异无统计学意义（ P〉0.05）。静脉用药治疗1个月后,观察组患者生活质量的各项维度得分、依从性、规范治疗完成率均高于对照组；静脉用药治疗6个月后,两组患者依从性、规范治疗完成率有明显差异；静脉用药治疗9个月后,两组患者依从性差异显著,观察组规范治疗完成率是对照组的5.6倍。结论应重视耐多药肺结核患者规范治疗过程中的生活质量,PICC能明显提高长期输液者的生活质量和依从性,提高强化期治疗的完成率,值得在临床上推广。

Objective To study the effect of PICC on intensive phase treatment of the patients with multi-drug resistant pulmonary tuberculosis. Methods A total of 64 cases of patients with multi-drug resistant pulmonary tuberculo-sis from January 2010 to January 2013 were selected as the research objects. All the patients and their families were giv-en individual health education, and then 32 cases who agreed to accept PICC infusion therapy were as the observation group, while the other 32 cases were taken as the control group. Differences in life quality of the patients of the two groups were compared by Quality of Life rating scale SF-36 before intravenous drug therapy and a month later after the intravenous medication. The compliance and the completion rate of standard treatment of different infusion routes after in-travenous medication for 1 month, 6 months and 9 months were observed respectively by the self-made scale. Results Each dimension score of life quality of the patients of the two groups had no statistical difference before treatment （ P〉0. 05） . After intravenous medication for 1 month, each dimension score of life quality, compliance and the completion rate of standardized treatment of the patients of observation group were higher than that of the control group;after intra-venous medication for 6 months, the compliance, the completion rate of standardization treatment of the two groups shp-wed obvious differences;after intravenous medication for 9 months, there were great differences in terms of compliance between the two groups. And the standard treatment completion rate of the observation group was 5. 6 times of the con-trol group. Conclusion The quality of life of the patients with multi-drug resistant pulmonary tuberculosis should be paid more attention to during the course of standard treatment. PICC can significantly improve the quality of life and compliance for those who need long time transfusion, and can improve the completion rate of the treatment at the inten-sive phase, it is worth wide clinical application.