Pomerantz M, Brown J
Section of General Thoracic Surgery, University of Colorado Health Sciences Center, Denver 80262, USA.
Semin Thorac Cardiovasc Surg. 1995 Apr;7(2):108-11.
Due to unpredicted factors, the incidence of tuberculosis is increasing in the United States. Despite excellent anti-tuberculous medication, some patients will require surgical management. The majority of these patients present with multi-drug-resistant tuberculosis (MDRTB). Surgery is indicated, but only after the best possible anti-tuberculous regime has been instituted. In those patients who become sputum-negative and have a destructive pulmonary process, or in those patients with persistent positive sputum and destroyed pulmonary parenchyma, operative management may be beneficial. Surgery can be done with a low mortality and morbidity incidence. Muscle flaps are useful in minimizing postoperative complications. Continued postoperative medical therapy combined with surgery offers a cure in more than 90% of patients. In patients with MDRTB and localized parenchyma disease, surgery combined with continued medical therapy is the treatment of choice in the majority of patients.
由于一些不可预测的因素，美国的结核病发病率正在上升。尽管有出色的抗结核药物，但仍有一些患者需要手术治疗。这些患者大多数患有耐多药结核病（MDRTB）。手术是可行的，但只有在采用了最佳的抗结核治疗方案之后才行。对于那些痰菌转阴且有肺部破坏性病变的患者，或者对于那些痰菌持续阳性且肺实质已被破坏的患者，手术治疗可能有益。手术的死亡率和发病率较低。肌瓣有助于将术后并发症降至最低。术后继续进行药物治疗并结合手术，可使超过90%的患者治愈。对于患有MDRTB和局限性实质病变的患者，手术结合持续的药物治疗是大多数患者的首选治疗方法。
