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[结核病的化疗——依从性、副作用及复发率]

[Chemotherapy of tuberculosis--compliance, side effects and incidence of recurrence].

作者信息

Brändli O, Häcki M A, Scheel A, Stiefel M

出版信息

Schweiz Med Wochenschr. 1983 Jan 22;113(3):92-6.

PMID:6828844
Abstract

In the years 1977-1980 290 patients were treated for pulmonary tuberculosis with standardized therapy: for the first five months isoniazid (INH), ethambutol (EMB) and rifampicin; INH and EMB were then continued for a total of up to 9-18 months (average 15 months). The patients' own physicians accepted the recommended duration of therapy in 85% of cases. During hospitalization, 96% of tests for INH in the urine were positive. Side effects, primarily consisting of elevated transaminases, were observed in 48% of the patients. 21-63 months after the beginning of therapy, reexamination of 220 of the patients showed 2 failures and 5 relapses. The relapses can be attributed to poor patient compliance (3 patients), a slow healing process with negative cultures only after 2 or more months of therapy (3 patients) and/or too short duration of therapy: 3 of the 7 patients treated for less than 9 months suffered relapses. Before administering short term therapy of 9 months or less in Switzerland it is necessary to take into consideration the age distribution, history and stage of the disease in the patients and our system of health care by family physicians.

摘要

1977年至1980年期间,290例肺结核患者接受了标准化治疗:前五个月使用异烟肼(INH)、乙胺丁醇(EMB)和利福平;之后INH和EMB继续使用,总共持续9至18个月(平均15个月)。在85%的病例中,患者的主治医生接受了推荐的治疗时长。住院期间,96%的尿液INH检测呈阳性。48%的患者出现了副作用,主要表现为转氨酶升高。治疗开始后21至63个月,对220例患者进行复查,发现2例治疗失败和5例复发。复发原因可能是患者依从性差(3例)、治疗过程缓慢,治疗2个月或更长时间后培养结果才转阴(3例)和/或治疗时长过短:7例治疗时间少于9个月的患者中有3例复发。在瑞士实施9个月或更短时间的短期治疗之前,有必要考虑患者的年龄分布、疾病史和阶段以及我们的家庭医生医疗保健系统。

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