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目的 :应用氧氟沙星丁胺卡那霉素联合治疗难治性肺结核病并观察其疗效。方法 :对 2 1例难治性肺结核病人进行治疗。治疗方案为 :强化期 3～ 6个月 ,氧氟沙星 0 .6g/d ,丁胺卡那霉素 0 .6g/d ,雷米封 0 .6g/d ,利福平 0 .6g/d和吡嗪酰胺 2 .0g/d ;巩固期时停用丁胺卡那霉素和吡嗪酰胺 ,其他药物剂量不变 ,继续服用 ;总疗程 2年。治疗方法每天 1次顿服。观察指标 :每月查肝肾功能、血尿常规及痰查抗酸杆菌 3次 ,每 3个月拍胸片 1次及观察用药的副作用 ,观察标准主要是细菌学指标和胸片指标。结果 :治疗后痰菌阴转率 71.4 3%(15 /2 1) (P <0 .0 1) ;病灶吸收好转率为 71.4 3(15 /2 1) (P <0 .0 1) ;空洞缩小或闭合率为 4 7.6 2 % (10 /2 1) (P<0 .0 5 )。结论 :①对于难治性结核病必须要联合应用敏感的药物 ,并要延长治疗时间才能有效地得到控制 ;②氧氟沙星和丁胺卡那霉素同时应用 ,才能有效地延缓耐药性 ,保障治疗效果
Objective: The application of ofloxacin amikacin combined treatment of refractory pulmonary tuberculosis and observe its efficacy. Methods: Twenty-one patients with refractory pulmonary tuberculosis were treated. Treatment regimen: strengthening period of 3 to 6 months, ofloxacin 0 .6g / d, amikacin 0 .6g / d, Remy Seal 0. 6g / d, rifampin 0. 6g / d and pyrazinamide 2 .0g / d; Consolidation period withdrawal of amikacin and pyrazinamide, the other drug dose unchanged, continue to take; total course of treatment for 2 years. Treatment 1 day a day service. Observations: Check the liver and kidney function every month, urine and urine sputum check acid bacilli 3 times, every 3 months to take chest radiograph 1 times and observe the side effects of medication, the observation criteria are mainly bacteriological indicators and chest X-ray indicators. Results: After treatment, the sputum negative conversion rate was 71.4 3% (15/2 1) (P <0.01), and the recovery rate of lesions was 71.4 3 (15/21) (P <0.01) The reduction or closure rate was 4 7.6 2% (10/2 1) (P <0.05). Conclusions: ① For tuberculosis patients with refractory tuberculosis, the combination of sensitive drugs and prolonged treatment time can be effectively controlled; ② At the same time, ofloxacin and amikacin can effectively delay the drug resistance, Protection of treatment