耐多药肺结核早期外科治疗的临床研究-第三军医大学学报.DOCVIP

耐多药肺结核早期外科治疗的临床研究 叶嗣宽1，赵 攀3，杨传利2，秦禄武4，陈 佳1，谢渝中3 （400036重庆，重庆市公共卫生医疗救治中心：胸外科1，手术室2，普外科3；404040重庆万州，万州区第四人民医院外二科4） [摘要]目的 探索耐多药肺结核早期外科治疗的手术时机，为优化耐多药肺结核治疗方案提供询证医学依据。方法 选取本院2006年7月至2010年6月间予以手术治疗的耐多药肺结核患者共42例作为观察组（一般情况，进行病肺切除，术后继续予以有效药物化疗12个月以上），另随机选取43例（一般情况，根据药敏试验选取有效化疗药物内科治疗）有肺叶切除指征的单纯化疗的耐多药肺结核患者作为对照组。两组患者均予以连续不间断随访12～24个月，对比分析两组患者痰菌转阴、并发症发生率、死亡率等临床指标。结果 对照组痰菌阴转率42%，死亡率16%；观察组痰菌转阴率79%，并发症发生率29%，死亡率2%。两组治愈率、死亡率比较有统计学差异（P＜0.05）。结论 对确诊耐多药肺结核，经内科治疗2月以上者均可考虑手术治疗，早期手术治疗效果优于晚期手术治疗，其手术并发症可接受。 [关键词]耐多药肺结核；外科手术；手术时机；痰菌转阴率；并发症 Clinical research on multiple drug resistance tuberculosis early surgical treatment Yesikuan，yangchuanli，Qinluwu，xieyuzhong，chenjia，zhaopan（作者单位署名的英文翻译？） [abstract] objective to explore more resistant tuberculosis medicine early surgical treatment of timing of surgery， in order to optimize the resistance to many medicine tuberculosis treatment plan for provide evidence base. Methods： we selected in July 2006 - June 2010 to between the surgical treatment of resistance to many medicine tuberculosis patients a total of 42 people as the observation group， the other random select 43 cases had lobectomy combined with indication of resistance to many medicine tuberculosis patients as control group contrast research between groups，control group according to the quick experiment of medicine selecting the effective chemotherapy drugs medical treatment，observation groups disease lung resection，continue to be eff- ective after chemotherapy drugs more than 12 months，two groups of patients shall be continuous uninterrupted 12～24 months follow-up， the two groups of patients sputum bacteria，shade，complications， mortality，etc are co-mpared and analyzed. Results：the control group phlegm genii feminine changed rate was 40%， and mortality was 21%； The observation group sputum bacteria， shade rate 79%， complication rate was 29%， and mortality was 2%. Two groups of cure rate， mortality is statistically significant （P 0.05）. Conclusion： the diagnosis more resi