论文部分内容阅读
地点:印度新德里结核病研究所儿童肺病科。目的:评价儿童肺结核患者在DOTS策略下的治疗转归。设计:对1 098例儿童肺结核患者的资料进行回顾性分析。结果:在本研究中,儿童肺结核患者的平均年龄11.2岁,女性(61.7%)多于男性(38.3%)。0～5、6～10和11～14岁年龄组病人分别占18.3%、26.6%和55.1%。病人的登记分类包括:新病人(87.7%)、复发(1.9%)、失败(1.0%)、丢失返回(5.0%)、迁入(0.9%)和其他(3.5%)。在全部患者中,痰涂片阳性者414例,阴性者404例,未痰检或检查结果不详者280例。痰涂片阳性率随年龄而增高。使用Ⅰ类、Ⅱ类和Ⅲ类治疗方案的患者分别占50.6%、10.5%和38.9%。新病人和复治病人的治愈率分别为92.4%(302/327)和92%(80/87)(x_1~2=0.02, P=0.901)。但新病人的治疗完成率(97%, 636/656)明显高于复治病人(53.6%,15/28) (x_1~2=100.8,P<0.001)。新病人和复治病人的治疗成功率分别为95.4%和82.6%(x_1~2=30.35, P<0.001)。总的说来,治疗转归为丢失、失败和死亡的患者比例分别占3%、1.9%和1%。结论:DOTS的确是高效的治疗管理策略。
Location: Children’s Lung Division, Tuberculosis Institute, New Delhi, India. PURPOSE: To evaluate the therapeutic outcome of pediatric patients with tuberculosis under the DOTS strategy. Design: A retrospective analysis of data on 1,098 children with pulmonary tuberculosis. RESULTS: In this study, children with tuberculosis had a mean age of 11.2 years, with 61.7% of women being more than men (38.3%). The patients in 0 ~ 5, 6 ~ 10 and 11 ~ 14 age groups accounted for 18.3%, 26.6% and 55.1% respectively. Patient enrollment categories included: new patient (87.7%), relapse (1.9%), failure (1.0%), loss of return (5.0%), move in (0.9%) and others (3.5%). In all patients, sputum smear positive in 414 cases, 404 cases were negative, no sputum examination or examination results unknown in 280 cases. The positive rate of sputum smear increased with age. Patients using Class I, II and III treatment accounted for 50.6%, 10.5% and 38.9%, respectively. The cure rates for new patients and re-treatment patients were 92.4% (302/327) and 92% (80/87), respectively (x_1 ~ 2 = 0.02, P = 0.901). However, the completion rate of new patients (97%, 636/656) was significantly higher than that of retreatment patients (53.6%, 15/28) (x_1 ~ 2 = 100.8, P <0.001). The success rates of new patients and re-treatment patients were 95.4% and 82.6%, respectively (x_1 ~ 2 = 30.35, P <0.001). Overall, the proportion of patients whose treatment outcomes were lost, failed and died accounted for 3%, 1.9% and 1%, respectively. Conclusion: DOTS is indeed an effective treatment management strategy.