药物耐药结核病患者在辅助切除肺部手术后的临床结果
概括
辅助肺部手术为耐药结核病 (DR-TB) 提供了一种可行的治疗方法. 这种方法与二线药物相结合,在RR-TB,MDR-TB和XDR-TB患者中显示出高治愈率和生存率.
科学领域:
- 肺部医学
- 传染性疾病
- 外科瘤学
背景情况:
- 耐药结核病 (DR-TB) 是全球卫生面临的一个重大挑战.
- 抗药性结核病的标准治疗方案往往是漫长的,并伴有相当大的毒性.
- 作为抗药性结核病治疗的辅助手术仍然是一个研究领域.
研究的目的:
- 在被诊断为耐药结核病的患者中评估辅助切除肺部手术的疗效和安全性.
- 分析各种DR-TB手术后的临床结果,包括治愈和存活率.
- 评估二线抗结核药物治疗与手术相关的作用.
主要方法:
- 在2015年1月至2019年1月期间,连续40名患者接受了DR-TB肺切除的回顾性分析.
- 这些患者包括耐利结核病 (RR-TB),多抗药性结核病 (MDR-TB) 和广泛抗药性结核病 (XDR-TB) 患者.
- 对临床结果进行了评估,对患者进行了至少5年的随访,包括唾液转换,培养转换,治愈和存活率.
主要成果:
- 这项研究包括RR- TB (17. 5%),MDR- TB (57. 5%) 和XDR- TB (25. 0%) 的患者,所有患者都接受二线抗结核药物治疗.
- 外科手术包括叶切除术 (62.5%) 和肺切除术 (15.0%),整体并发症率为12.5%.
- 术后结果显示高效,液涂抹转化率为89. 5%,培养转化率为91. 3%,整体治愈率和生存率为97. 5%.
结论:
- 在RR/MDR/XDR-TB患者中,辅助切除肺部手术是一种可行的和有效的治疗选择.
- 结合手术和适当的二线抗结核药物治疗对于实现良好的临床结果至关重要.
- 这项研究强调了手术治疗改善复杂DR-TB病例治愈率和生存率的潜力.
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