医学
外科
痰
肺结核
化疗
楔形切除术
回顾性队列研究
全肺切除术
多重耐药
痰培养
病历
抗药性
肺
内科学
切除术
病理
微生物学
生物
作者
Park Sk,Lee Cm,Heu Jp,Song Sd
出处
期刊:PubMed
日期:2002-02-01
卷期号:6 (2): 143-9
被引量:43
摘要
Outcome of treatment using only chemotherapy for multidrug-resistant tuberculosis is usually considered not to be satisfactory. The combination of chemotherapy with surgical treatment has been producing higher acid-fast bacilli (AFB) negative sputum conversion and longer survival rates. This treatment strategy may be the solution for patients with multidrug-resistant tuberculosis.A retrospective review was performed of the medical records and laboratory findings of 49 patients with multidrug-resistant tuberculosis among 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital, Korea.The mean number of drugs to which the patients were resistant was 4.5. Patients had a mean age of 35 years. Cavitary lesions on plain chest X-ray were shown in 43/49 patients (87.8%); 31 had positive sputum cultures preoperatively (63.3%). The surgical techniques used were as follows: 12 pneumonectomies, 28 lobectomies, seven lobectomies with segmentectomies or wedge resections, one wedge resection and one cavernoplasty. The AFB negative sputum conversion rate was 93.5% with continuous postoperative chemotherapy. There were no deaths after surgery. Postoperative complications that developed were six cases of air leakage over a week, one of postoperative bleeding and one of wound infection.This study demonstrated the effectiveness of pulmonary resection with postoperative chemotherapy in cases of multidrug-resistant tuberculosis. Although there are different ideas about indications for surgery and the length and content of postoperative drug regimens, pulmonary resection should be considered an effective measure in combination with chemotherapy for treatment of multidrug-resistant pulmonary tuberculosis.
科研通智能强力驱动
Strongly Powered by AbleSci AI