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目的通过分析耐多药肺结核患者发现和治疗情况,探索适合中国国情的耐多药肺结核患者发现及治疗策略。方法采用月报表、季报表收集患者发现、治疗及痰菌阴转数据,通过分析耐多药肺结核患者筛出率评价高危人群筛查的患者发现策略;通过分析标准化治疗方案使用情况以及6月末痰菌阴转情况,评价耐多药标准化治疗策略。结果耐多药2 657例可疑患者进行药敏试验,880例(33.1%)确诊为耐多药肺结核;其中经过治疗前体检和医生评估的814例患者,仅有473例(58.1%)纳入治疗,433例(91.5%)接受标准化治疗;完成6个月治疗的124例患者中,痰涂片和痰培养阴转率分别为67.7%和63.7%。结论耐多药肺结核高危人群筛查是适合中国目前技术能力和资源情况,符合成本效益的患者发现策略;标准化治疗方案能够满足大部分患者治疗需求,并获得理想的痰菌阴转率。
Objective To explore the discovery and treatment of MDR-TB patients and to explore the strategy of finding and treating MDR-TB patients suitable for China’s national conditions. Methods Monthly reports, quarterly reports were collected for patient discovery, treatment, and sputum negative conversion data. Patients were also evaluated for screening strategies in high-risk populations by screening out multidrug-resistant tuberculosis screening rates. By analyzing the use of standardized treatment protocols and sputum aspiration in late June, Negative changes in bacteria, evaluation of multidrug-resistant standard treatment strategy. Results A total of 2,657 suspicious patients were tested for susceptibility to MDR and 880 (33.1%) were diagnosed as MDR-TB. Among the 814 patients who underwent pre-treatment and medical assessment, only 473 (58.1%) were included in the treatment , And 433 cases (91.5%) received standardized treatment. Among 124 patients who completed 6 months of treatment, the sputum smear and sputum culture negative conversion rates were 67.7% and 63.7%, respectively. Conclusions Screening at high risk for MDR-TB is a cost-effective strategy for patient discovery that is tailored to the current state of technological capabilities and resources in China; standardized treatment meets most patients’ treatment needs and achieves an ideal sputum negative conversion rate.