Vencevicius Vladas
Republican Santariskes Tuberculosis and Lung Diseases Hospital, Santariskiu 14, 2021 Vilnius, Lithuania.
Medicina (Kaunas). 2004;40 Suppl 1:131-3.
The problem of multidrug-resistance is urgent because the part of these patients undergoes treatment failure after chemotherapy. In such cases the operations are performed. In 1998-2002 in the Department of Thoracic Surgery of Republic Santariskes Tuberculosis and Lung Disease Hospital 739 thoracic operations were performed for the patients with pulmonary tuberculosis. Because of multidrug-resistant pulmonary tuberculosis 355 patients (48%) were operated on, radical operations were performed to 190 patients (53.5%) and for 165 (46.5%) - palliative. Positive outcome was documented for 324 patients (91.3%); 31 patients (8.7%) died. Various postoperative complications were confirmed in 76 cases (21.4%) when multidrug-resistance was determined. CONCLUSIONS. When multidrug-resistance is developed, clinic or radiological dynamics of tuberculosis process is not positive, after 3-4 months is it necessary to discuss the question of the operation. In case of monolateral process the radical operations with the type of resection are performed, but in case of widespread process and various complications palliative operations are performed. The treatment with antituberculotic drugs when patient is operated on because multidrug-resistance is continued for 22-24 months.
多重耐药问题十分紧迫，因为这些患者中有一部分在化疗后会出现治疗失败的情况。在这种情况下会进行手术。1998年至2002年期间，在共和国桑塔里克斯结核病和肺病医院胸外科，为肺结核患者进行了739例胸科手术。由于耐多药肺结核，对355例患者（48%）进行了手术，对190例患者（53.5%）进行了根治性手术，对165例患者（46.5%）进行了姑息性手术。324例患者（91.3%）记录有阳性结果；31例患者（8.7%）死亡。在确定耐多药时，76例（21.4%）出现了各种术后并发症。结论。当出现耐多药情况，结核病进程的临床或放射学动态不佳时，在3至4个月后有必要讨论手术问题。对于单侧病变，进行根治性切除手术，但对于广泛病变和各种并发症，则进行姑息性手术。当患者因耐多药而接受手术时，抗结核药物治疗要持续22至24个月。
