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目的分析上海市静安区结核病患者的治疗结局,深入了解肺结核患者治疗结局的影响因素。方法调查在静安区1999年1月到2008年12月确诊的901例肺结核患者。采用SPSS 12.0统计软件,进行单因素χ2检验和多因素logistic回归分析,P<0.05为差异有统计学意义。结果肺结核病人的总治愈率为88.3%。单因素分析显示:年龄(<60岁与≥60岁两组)、性别、职业种类、合并症、化疗史、痰涂片、副反应及服药规律、病灶范围大小等9个因素与治疗结果有关(P<0.05)。多因素分析显示:性别、复治、肺部病变灶范围、服药是否规律及合并症是影响治疗结局的主要因素(P<0.05)。结论 (1)服药的规范、复治、合并症、性别及肺部病灶范围是影响肺结核治疗的主要因素。(2)对复治或有合并症或病灶范围累及较大尤其是5个肺野以上的患者采取有针对性的合理治疗方案,加强心理疏导,提高结核治疗及抗结核药服用积极性,规范服药。(3)特别关注提高男性患者治疗的依从性。
Objective To analyze the treatment outcomes of tuberculosis patients in Jingan District of Shanghai and to understand the influencing factors of tuberculosis patients’ treatment outcome. Methods A total of 901 pulmonary tuberculosis patients were diagnosed in Jingan District from January 1999 to December 2008. Using SPSS 12.0 statistical software, single factor χ2 test and multivariate logistic regression analysis, P <0.05 for the difference was statistically significant. Results The total cure rate of tuberculosis patients was 88.3%. Univariate analysis showed that there were 9 factors related to the outcome of the treatment (age <60 and ≥60 years old), gender, occupational category, comorbidities, chemotherapy history, sputum smear, side effects and medication pattern, (P <0.05). Multivariate analysis showed that gender, retreatment, the range of lung lesion, the regularity of taking medicine and the complication were the main factors affecting the outcome (P <0.05). Conclusions (1) The main factors affecting the treatment of tuberculosis are the standard of medication, retreatment, comorbidity, gender and the range of lung lesions. (2) Take targeted and reasonable treatment programs for retreatment or patients with comorbidities or lesions, especially those with more than 5 lung fields, strengthen psychological counseling, increase the enthusiasm of taking TB treatment and anti-TB drugs, and standardize the medication . (3) Pay special attention to improving the compliance of male patients with treatment.