《儿科学精品教学资料》9 原发型肺结核-英.pptVIP

* * * * * (Ⅴ) other auxiliary examination 1、Finding tubercle bacillus in sputum or gastric juice 2、Superficial lymph node biopsy 3、Peripheral blood 4、ESR 5、Flexible bronchofiberscope examination 6、Antibody of TB Ⅳ、diagnose Ⅴ、Differential Diagnosis 1、before Chest X-ray inspection URI、tracheitis、rheumatic fever 2、After Chest X-ray inspection pneumonia、bronchiectasis Ⅵ、treatment principle：early, combine, appropriate amount, regularity、whole range Untreated TB: at least 10 persons /per 100 persons resistant for a anti-TB drug, there is at least 1 person/per 100 persons resistant for MDR-TB (multi-drug resistant). Re-treated TB (previous accepted anti-TB treatment more than one month): at least 20 persons/per 100 persons of a drug resistance, 7 persons/per 100 persons MDR-TB. course：Short-term therapy general treatment：Rest, Nutrition, regular life Drug therapy：6HR或9HR， Serious：add on S2月（2SHR/4~6HR） or Z3月（3HRZ/3~6HR） Drug Classification：USA Ⅰ— Maximum effect，Minimal toxicity eg：INH、RFP Ⅱ— Greater effect，Greater toxicity eg：SM、EMB、PZA Ⅲ— Minimal effect，Maximum toxicity eg：KM、CS Ⅵ、treatment the basic mechanism of Short treatment ： Fast kill tubercle bacillus in the boday Different propagation speed inside and outside of the Cells The basic characteristics of short-term therapy: 1、sputum culture turn negtive quickly 2、low incidence of the long-term recurrence 3、full course of treatment failure less, the high rate of sputum culture turn negtive 4、with less drug side effects high efficacy, less toxicity, few cost, and could prevent drug-resistant strains Ⅵ、treatment Ⅶ Prognosis Clinical symptoms: turn for the better after 3~6 months Required 2-year improvement in pathological recovery quiescence progression deterioration Low immunization * * 报告发病数居前五位的病种依次为病毒性肝炎、肺结核、梅毒、细菌性和阿米巴性痢疾、淋病，占乙类传染病报告发病总数的94.41%，报告死亡数居前五位的病种依次为艾滋病、肺结核、狂犬病、病毒