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目的南阳市结核病防治所探讨抗结核治疗过程中类赫氏反应的临床特点,旨在提高医务人员对类赫氏反应的认识。方法回顾性分析南阳市结核病防治所2005年1月—2009年1月2756例初治肺结核患者治疗过程中发生类赫氏反应的病例及临床特征。结果发生类赫氏反应22例,类赫氏反应发生率为0.80%。类赫氏反应多发生在31±0.3岁。22例中病灶总面积≥3个肺野占19例、痰菌阳性16例。类赫氏反应出现于开始化疗2个月内占95.5%,呈一过性或暂时性病灶恶化表现。结论类赫氏反应多发生于抗结核治疗前2个月,初治年青患者多,与病灶范围广,痰菌量大等有关。抗结核治疗过程中出现类赫氏反应,不需要更改治疗方案,只需要对症处理并坚持原方案治疗,临床表现很快会好转或消失。
Objective Nanyang Tuberculosis Prevention and Treatment Institute to explore the clinical features of Hechshehr reaction in the course of anti-TB treatment aimed at improving medical staff awareness of Hatch’s reaction. Methods A retrospective analysis of Nanyang Tuberculosis Prevention and Control Center from January 2005 -2009 in January 2756 cases of newly diagnosed tuberculosis patients with Heath-like reaction during the treatment of cases and clinical features. Results Hechsia reaction occurred in 22 cases, the incidence of Herz-like reaction was 0.80%. Hysteric reactions occurred in more than 31 ± 0.3 years old. In 22 cases, the total area of lesions ≥ 3 lung fields accounted for 19 cases, sputum positive 16 cases. Herzheimer’s reaction occurred in 95.5% within 2 months of starting chemotherapy, showing transient or temporary deterioration of the performance. Conclusions Herzheimer’s reaction occurred more than 2 months before antituberculosis treatment. There were many young patients with initial treatment, which was related to the wide range of lesions and the large amount of sputum bacteria. In the process of anti-TB treatment, Hodgkin’s reaction appears like no need to change the treatment plan, only need symptomatic treatment and adhere to the original plan of treatment, the clinical manifestations will soon improve or disappear.