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目的评价不同治疗方案对复治肺结核患者的治疗效果。方法采用前瞻性队列研究方法,收集收治的167例复治涂阳肺结核患者,分为4组并分别采用不同治疗方案进行治疗,比较各组治疗效果、不良反应发生率及复发情况。结果 3个试验组患者在病灶吸收、痰菌阴转、成功治疗率和复发率等方面均优于对照组,其中高剂量组、长疗程组和个体化方案组满疗程痰菌阴转率分别为91.1%、92.5%和90.0%,高于对照组(71.4%),各组间差异有统计学意义(X~2=9.63,P=0.02)。高剂量组、长疗程组、个体化方案组和对照组治疗成功率分别为91.1%、90.0%、87.5%和71.4%,各组间差异有统计学意义(X~2=8.38,P=0.04)。患者在治疗过程中3个试验组不良反应发生率均高于对照组,但差异无统计学意义。结论不同化疗方案对复治肺结核患者的治疗效果有一定的差异,其中以高剂量和长疗程治疗方案疗效较好。
Objective To evaluate the therapeutic effect of different treatment regimens on patients with retreated pulmonary tuberculosis. Methods A prospective cohort study was conducted in 167 patients with relapsed and smear-positive pulmonary tuberculosis. The patients were divided into 4 groups and treated with different treatment regimens respectively. The treatment effect, incidence of adverse reactions and relapse rate were compared between the two groups. Results The patients in the three experimental groups were better than the control group in the aspects of lesion absorption, sputum negative conversion, successful treatment rate and recurrence rate. Among them, the high-dose group, long-course group and individualized program group Which was 91.1%, 92.5% and 90.0% respectively, which was higher than that of the control group (71.4%). There was significant difference among the groups (X ~ 2 = 9.63, P = 0.02). The success rates of high-dose group, long-course group, individualized group and control group were 91.1%, 90.0%, 87.5% and 71.4%, respectively. The difference between the two groups was statistically significant (X 2 = 8.38, P = 0.04 ). Patients in the course of treatment of adverse reactions in the three experimental groups were higher than the control group, but the difference was not statistically significant. Conclusion Different chemotherapy regimens have different effects on the treatment of patients with relapsed pulmonary tuberculosis. Among them, high-dose and long-term treatment regimens are effective.