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目的了解耐多药肺结核患者(MDRTB)临床疗效及其转归,以进一步提高对注射期重要性的认识,探讨MDRTB患者管理办法。方法选取2009年10月至2011年1月南通市第六人民医院收治的经南通市疾病预防控制中心和南通市第六人民医院药物敏感试验证实的MDRTB患者76例,分为注射期末阳性组、阴性组和未查组,观察3组间临床疗效、不良反应、转归等。结果注射期末痰菌阴性组痰菌阴转率、病灶吸收率、空洞闭合率均明显高于痰菌阳性组和未查组,而不良反应发生率在3组间差异无统计学意义。涂阴组治愈率明显高于涂阳组和未查组,差异有统计学意义(χ2=23.276,P<0.05)。结论 MDRTB患者中,注射期末痰菌阴性组临床疗效及转归明显好于涂阳组和未查组。重视规范MDRTB患者注射期治疗及定期监测,加强督导管理,可提高治愈率。
Objective To understand the clinical efficacy and outcomes of multidrug-resistant tuberculosis (MDRTB) patients in order to further improve the understanding of the importance of injection and explore the management of MDRTB patients. Methods From October 2009 to January 2011, Nantong Sixth People’s Hospital admitted 76 patients with MDRTB confirmed by Nantong Center for Disease Control and Prevention and the Sixth People’s Hospital of Nantong City. The patients were divided into positive group, Negative group and did not check the group, observe the clinical efficacy between the three groups, adverse reactions, prognosis and so on. Results At the end of injection, sputum negative conversion rate, lesion absorption rate and void closure rate were significantly higher than sputum positive group and unchecked group, but the incidence of adverse reactions was not statistically significant among the three groups. The cure rate of smear-negative group was significantly higher than that of smear-positive group and unidentified group (χ2 = 23.276, P <0.05). Conclusion In MDRTB patients, the clinical efficacy and prognosis of sputum negative group at the end of injection are obviously better than those of smear positive group and unidentified group. Emphasize the standard MDRTB injection treatment and regular monitoring, strengthen supervision and management, can improve the cure rate.