Khomenko A G, Mishin V I
Central Scientific Institute of Tuberculosis RAMN, Moscow.
Probl Tuberk. 1996(5):21-3.
An examination was made of 77 patients with extensive segmentary and lobular pulmonary tuberculous lesions: caseous pneumonia (n = 26), infiltrative caseous pneumonia (n = 18), fibrocavernous pneumonia complicated by caseous pneumonia (n = 16), and disseminated tuberculosis (n = 17). All patients had destructive changes; in 82.7% of patients the caverns were large and great in size. Bacteria were isolated in 94.8%, mycobacterial drug resistance was noted in 51.8%. Four variants of the course of a disease were identified: 1) that with predominance of the intoxication syndrome (41.6%); 2) that with respiratory failure (24.7%); 3) that with pulmonary hemorrhage (15.6%), 4) that added by secondary microorganisms (18.2%). Chemotherapy included a combination of 4 or 5 drugs along with pathogenetic tools, which stabilized a process in 80% of patients and arrested bacterial isolation in 69.5%. In 20%, the process continued to progress and in 3 of them died.
对77例患有广泛节段性和小叶性肺结核病变的患者进行了检查:干酪性肺炎(n = 26)、浸润性干酪性肺炎(n = 18)、合并干酪性肺炎的纤维空洞性肺炎(n = 16)和播散性肺结核(n = 17)。所有患者均有破坏性改变;82.7%的患者空洞大且数量多。94.8%的患者分离出细菌,51.8%的患者存在分枝杆菌耐药。确定了疾病的四种病程类型:1)以中毒综合征为主的类型(41.6%);2)伴有呼吸衰竭的类型(24.7%);3)伴有肺出血的类型(15.6%);4)合并继发微生物感染的类型(18.2%)。化疗包括4种或5种药物联合病因治疗药物,80%的患者病情得到稳定,69.5%的患者细菌分离停止。20%的患者病情继续进展,其中3例死亡。