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。
