初治空洞性肺结核49例临床研究.docVIP

初治空洞性肺结核49例临床研究【摘要】 目的 探讨初治空洞性肺结核的临床特点及短程化疗方案效果。方法 回顾性分析临床确诊的49例空洞性肺结核患者临床资料。结果 49例患者中咳嗽45例,发热43例,乏力、盗汗27例,痰涂片阳性36例。X线胸片表现为单发、薄壁、干酪性空洞43例,病变累及2个以上肺野34例。6个月疗程结束后,病程小于30 d者空洞治疗有效率为75.6%,病程大于30 d者空洞治疗有效率为42.1%。结论 初治空洞性肺结核多有典型的结核中毒症状,X线胸片以单发、薄壁、干酪性空洞为主,病变累及多个肺野,早期治疗有利于空洞的吸收。 【关键词】 初治;空洞性肺结核;临床分析 Initial treatment cavitary pulmonary tuberculosis clinical analysis MA Yue-ping,FENG Shang-jie,MA Xue-ping. Center for Disease Control and Prevention,Wu zhong,751100, China 【Abstract】 Objective To explore effect of initial treatment cavitary pulmonary tuberculosis in clinical characteristics and short-course chemotherapy.Methods Retrospective analysis clinical data of 49 definite cases. Results There are 45 case of cough, 43 cases of fever, 27 cases hypodynamia and night sweat and 36 case of sputum smear positive.Chest X-ray show in 43 cases with single,thin-walled and caseous cavity, 34 cases with lesions involved over 2 lung fields. 6 months after the therapy was done, when the diabetic duration of less than 30 days,cavity curative effect rates were 75.6%, the diabetic duration of less than 30 days, cavity curative effect rates were 42.1%. Conclusion Most of them have typical toxic symptoms of phymatiosis, Chest X-ray show single,thin-walled and caseous cavity, lesions involved multiple lung fields, early treatment beneficial to absorption of cavity. 【Key words】 Initial treatment;Cavitary pulmonary tuberculosis;Clinical analysis 肺结核是严重危害人民群众健康的慢性人兽共患传染病,是全球关注的的公共卫生问题,是我国的常见病、多发病。近年来,肺结核的发病率和复发率呈逐年上升趋势[1],因此, 结核病患者的管理和治疗是结核病控制策略中一项非常重要的内容。结核病治疗成功的关键在于合理的化疗方案及有效地治疗管理[2],全程监督短程化疗是治疗肺结核的主要措施。现将我中心1993~2006年管理并完成6个月短程化疗的49例空洞性初治肺结核患者的临床特点及治疗效果回顾性分析总结如下。 1 临床资料与方法 1.1 一般资料 49例患者为我中心1993~2006年管理并完成短程化疗的初治空洞性肺结核患者,均无严重肝肾疾患。肺结核诊断采用中华医学会结核病分会2001年肺结核诊断标准[3]。49例患者中,男45例,女4例,年龄17~70岁,平均45岁,病程30 d 16例,并发糖尿病者10例,确诊前曾自行或于综合门诊抗炎治疗者36例。 1.2 方法 实验室检查采用X线胸片检查和痰涂片检查方法,治疗均采用DOTS策略短程化疗方案,即2H3R3Z3E3(S3)/4H3R3,合并糖尿病者予以降糖治疗。 2 结果 2.1 临床表现及实验室X线检查 咳嗽、咳痰45例,发热43例,乏