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目的了解北京市复治涂阳肺结核患者治疗现状及效果。方法选择2006—2007年北京市户籍复治涂阳患者,依其年龄、初治地点及就诊机构、初治管理方式、复治疗前药敏试验及合并症、并发病等,对使用2HRZE(S)/6HRE标准复治化疗方案(简称“标化方案”)的疗效及非标准复治化疗方案(简称“非标化方案”)使用情况进行分析。结果 223例,以中老年居多,占65.5%。治疗前54例进行药敏试验,耐药25例,耐药率46.3%(25/54),耐多药率13.0%(7/54)。使用标化复治方案170例,占76.2%,平均治愈率为75.9%。初治失败者治愈率为50%。使用非标化方案53例,占23.8%,原因为耐药、药物不良反应、伴有合并症、并发病等。结论为进一步提高复治病例的治愈率,在标化复治方案的基础上,对初治失败者复治前应作一、二线抗结核药品的药物敏感试验,并根据试验结果及个体状况。对不宜采用标化方案者可制定有效的个体化方案。
Objective To investigate the treatment status and effect of Fuzhi smear positive pulmonary tuberculosis patients in Beijing. Methods According to the age, place of initial treatment and treatment, management methods of initial management, drug susceptibility test before rehospitalization and complication and incidence of patients with resuscitation and resurfacing in Beijing from 2006 to 2007, ) / 6HRE standard regimen (referred to as “standard regimen”) and the use of non-standard regimen (referred to as “non-standard regimen”) were analyzed. The results of 223 cases, mostly in middle-aged, accounting for 65.5%. Drug susceptibility testing was performed in 54 cases before treatment, with resistance in 25 cases, resistance rate of 46.3% (25/54) and resistance rate of 13.0% (7/54). Standard regimen regimen used 170 cases, accounting for 76.2%, the average cure rate was 75.9%. The initial treatment failure rate of 50% cure. The use of non-standardized program in 53 cases, accounting for 23.8%, because of resistance, adverse drug reactions, associated with complications, and disease. Conclusions In order to further improve the cure rate of retreatment cases, based on the standardized regimen, drug susceptibility tests of first- and second-line anti-tuberculosis drugs should be made before recuperation. Based on the test results and individual status. For those who should not use the standardization program can develop effective individual programs.