96例耐药肺结核患者临床治疗结果分析

Analysis of clinical treatment outcome of 96 drug resistance pulmonary TB patients

目的 分析耐药肺结核患者的临床治疗方法与结果.方法 收集2012年4月至2014年12月在宁夏回族自治区第四人民医院呼吸一科住院治疗的96例耐药肺结核患者的临床资料,其中单耐药8例,多耐药2例,耐多药69例,广泛耐药17例.对患者既往治疗史加以分析,结合药物敏感性试验（简称“药敏试验”）结果,经专家组讨论制定合理的个体化治疗方案,并定期采用浓缩集菌荧光染色法行痰抗酸杆菌检测及固体罗氏培养法行痰结核分枝杆菌培养.患者在全程督导的情况下完成治疗方案,并监测患者在化疗期间痰菌阴转、胸部CT病灶吸收情况,以及用药期间有无不良反应等情况.结果 96例耐药肺结核患者中,治疗成功（治愈＋完成疗程）者68例,占70.83％;治疗失败者4例,占4.17％;失访者11例,占11.46％;死亡者4例,占4.17％;因药物不良反应中断治疗者9例,占9.37％.结论 有效的化疗方案、良好的患者用药依从性及有效的管理措施是耐药肺结核患者良好治疗转归的关键.

Objective To analyze the treatment outcome of drug resistance pulmonary rib patients. Methods Collect the clinical data of 96 drug resistance pulmonary TB cases hospitalized in the respiratory department of the Fourth Hospital of Ningxia Hui Automomous Region from ApT, 2012 to Dec, 2014. Including 8 cases of single drug resistance, 2 cases of poly-drug resistance, and 69 cases of MDR, and 17 cases of XDR. To analyze the history of past treatment and DST results, formulate individualized anti-TB therapeutic regimen through experts discussion. Periodically culture sputum Mycobacterium tuberculosis by concentrated fluorescent staining acid-fast bacilli test and solid Roche culture. Complete the therapy under the whole course supervision, and monitor the sputum conversion and CT lesions absorption, as well as adverse reaction. Results In 96 cases of the drug resistance pul- monary TB patients, 68 patients were successfully cured, which accounted for 70. 83% of all the cases. Four treat- ment failures represented 4.17% of the total cases. Eleven patients were loss of follow-up accounting for 11.46%. Four died accounted for 4. 17% in 96 cases. Nine patients discontinued treatment as a result of side-effects, which maked up 9.37% of the whole cases. Conclusion The clinical outcome and prognosis depend on patients adherence, reasonable anti-TB therapeutic regimen and effective DOT implementation.