Lin Chih-Bin, Sun Hung-Chieh, Chiang Chen-Yuan, Wu Che-Wei, Chou Hsu-Wen, Tang Tao-Qian, Lee Jen-Jyh
Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Department of Internal Medicine, Mennonite Christian Hospital, Hualien, Taiwan.
Tzu Chi Med J. 2019 Jan-Mar;31(1):35-39. doi: 10.4103/tcmj.tcmj_18_18.
The objective of this study is to evaluate the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) under special programmatic management in Eastern Taiwan over the past 10 years.
All newly diagnosed MDR-TB patients and MDR-TB patients enrolled previously with persistent positive cultures were included in this study, from May 2007 to April 2017, in Eastern Taiwan. A panel of pulmonologists designed the initial MDR-TB regimens. Subsequently, regimens were adjusted according to drug susceptibility test results for second-line drugs. Mobile teams were organized for treatment support, and several measures were adapted to safeguard effective treatment support.
A total of 178 patients with bacteriological confirmed pulmonary MDR-TB were identified, of whom 167 had treatment outcomes when the study was conducted. Of these 167 patients, 120 (71.9%) were cured, 11 (6.5%) completed therapy (78.4% had successful treatment), 25 (15.0%) died, 9 (5.4%) had treatment failure, none were transferred out, and 2 (1.2%) were lost to follow-up. Surgery was performed on 8 (4.8%).
This is an analysis of the treatment outcomes after adopting the Directly Observed Treatment, Short-course Plus program to treat MDR-TB patients in Eastern Taiwan. We had a low proportion of loss-to-follow-up, resulting in a high treatment success rate. This program serves as an effective model in providing quality care to patients with MDR-TB.
本研究的目的是评估过去10年台湾东部地区在特殊规划管理下耐多药结核病（MDR-TB）患者的治疗结果。
纳入2007年5月至2017年4月在台湾东部地区所有新诊断的MDR-TB患者以及先前登记且培养持续阳性的MDR-TB患者。由一组肺科医生设计初始MDR-TB治疗方案。随后，根据二线药物的药敏试验结果调整治疗方案。组建流动团队提供治疗支持，并采取多项措施确保有效的治疗支持。
共确定178例细菌学确诊的肺结核MDR-TB患者，在进行研究时其中167例有治疗结果。在这167例患者中，120例（71.9%）治愈，11例（6.5%）完成治疗（78.4%治疗成功），25例（15.0%）死亡，9例（5.4%）治疗失败，无患者转出，2例（1.2%）失访。8例（4.8%）接受了手术。
这是对台湾东部地区采用直接观察治疗短程强化方案治疗MDR-TB患者后的治疗结果分析。我们的失访率较低，治疗成功率较高。该方案是为MDR-TB患者提供优质护理的有效模式。
