耐多药肺结核患者实施标准化治疗方案后疗效观察及转归分析

Observation on Curative Effect and Conversion Analysis of Standardized Treatment Plan for Patients with Multi-drug Resistant Tuberculosis

目的观察耐多药肺结核患者实施标准化治疗方案后的临床疗效,并对治疗转归进行分析。方法方便选取2013年1月—2015年12月在内蒙古第四医院采用标准化肺结核化疗方案治疗且有明显转归的136例MDR-TB患者为研究对象。调查MDR-TB化疗转归情况及临床疗效。结果标准化疗后,初治MDR-TB患者痰敏试验转阴率明显高于复治MDR-TB患者(χ~2=17.573,P<0.05);初治、复治MDR-TB患者胸片病灶吸收率分别为82.7%和52.4%,差异有统计学意义(χ~2=21.903,P<0.05)。初治、复治MDR-TB患者肺部空洞闭合率分别为57.7%和39.3%,差异有统计学意义(χ~2=7.582,P<0.05)。初治、复治MDR-TB患者治疗成功率分别为82.7%和53.3%,差异有统计学意义(χ~2=20.680,P<0.05)。结论标准化疗方案治疗MDR-TB值得临床推广,初治MDR-TB的临床疗效与转归明显优于复治MDR-TB,所以进一步加强结核病患者的耐药监测,及早发现、治疗。

Objective To observe the clinical curative effect of standardized treatment plan for patients with multi-drug resistant tuberculosis and analyze the treatment conversion. Methods Convenient selection 136 cases of MDR-TB patients with standardized pulmonary tuberculosis chemotherapy plan and obvious conversion from January 2013 to December 2015 were selected as the research objects and the chemotherapy conversion of MDR-TB and clinical curative effect were surveyed. Results After the standardized chemotherapy, the sputum sensitivity test conversion rate of MDR-TB patients by initial treatment was obviously higher than that of MDR-TB patients by retreatment(χ~2=17.573,P<0.05), the chest film lesion absorption rate of MDR-TB patients by initial treatment and retreatment was respectively 82.7% and 52.4%, and the difference had statistical significance(χ~2=21.903,P<0.05), and the closure rate of pulmonary cavity of MDR-TB patients by initial treatment and retreatment was respectively 57.7% and 39.3%, and the difference had statistical significance(χ~2=7.582,P<0.05), and treatment success rate of MDR-TB patients by initial treatment and retreatment was respectively 82.7% and53.3%, and the difference had statistical significance(χ~2=20.680,P<0.05). Conclusion The standardized chemotherapy plan in treatment of MDR-TB is worth promotion, and the clinical curative effect and conversion of MDR-TB by initial treatment are better than those of MDR-TB by retreatment, therefore, we should further enhance the tolerance monitoring of patients with tuberculosis and discover and treat it as soon as possible.