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[关于肺结核细菌分离程度及结核分枝杆菌耐药性的外科治疗长期结果]

[Long-term results of surgical treatment of pulmonary tuberculosis wtih respect to the extent of bacterial isolation and to drug resistance of Mycobacterium tuberculosis].

作者信息

El'kin A V, Repin Iu M, Levashev Iu N

出版信息

Probl Tuberk Bolezn Legk. 2003(5):28-31.

Abstract

The remote postoperative results were followed up for as long as up to 10 years. It was established in case of abacillary patients that the frequency rate of relapses was minimal ranging from 3.6% in the group of patients operated for tuberculosis and caseous-necrotic tuberculosis to 11.5% in fibrous-cavernous tuberculosis. Patients with bacterial discharge, primarily of the extensive nature, had more often relapses (19.4% in operated patients for caseous-necrotic tuberculosis and 31.7% in patients operate for fibrous-cavernous tuberculosis). Drug resistance (DR) of Mycobacterium tuberculosis (MBT) to three and more anti-TB preparations essentially increase a possibility of relapses in all clinical forms of tuberculosis with maximum threat being in patients with fibrous-cavernous lesions (36%). As for the repeatedly operated patients for postoperative relapses involving DR MBT to isoniazid and rifampicin, only slightly above 50% of them survived 5 years after surgery; the index of the 5-year survival was 33% among the patients with DR to 4 and more drugs.

摘要

对术后远期结果进行了长达10年的随访。结果发现,在非菌阳患者中,复发率极低,从接受结核和干酪坏死性结核手术的患者组中的3.6%到纤维空洞性结核患者组中的11.5%不等。有排菌情况的患者,主要是广泛性排菌的患者,复发更为频繁(接受干酪坏死性结核手术的患者中复发率为19.4%,接受纤维空洞性结核手术的患者中复发率为31.7%)。结核分枝杆菌(MTB)对三种及以上抗结核制剂的耐药性(DR)基本上增加了所有临床类型结核病复发的可能性,其中纤维空洞性病变患者面临的威胁最大(36%)。对于因术后复发而再次接受手术、且MTB对异烟肼和利福平耐药的患者,术后5年仅有略高于50%的患者存活;对4种及以上药物耐药的患者,5年生存率为33%。

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