外科治疗非结核分枝杆菌肺病的临床疗效分析

发布时间：2018-05-15 19:25

本文选题：NTM肺病 + 外科手术　；参考：《临床肺科杂志》2016年11期

【摘要】：目的探讨外科手术治疗非结核分枝杆菌(NTM)肺病的疗效及时机,为优化非结核分枝杆菌(NTM)肺病治疗方案提供循证医学依据。方法以数字表法随机选取武汉市医疗救治中心胸外科2008年10月至2014年3月确诊的NTM肺病患者85例,其中观察组42例[男性28例,女性14例,年龄(36.6±1.0)岁]给予手术治疗,术后根据药敏结果用药治疗12个月以上;对照组43例[男性29例,女性14例,年龄(33.4±1.5)岁],根据药敏结果用药治疗18个月以上;随访24个月,观察对比两组患者治愈率、病情无变化例数(率)、病情逆转率、死亡率,并对观察组组不同病程患者的治愈率和并发症发生率进行比较。结果对照组治愈率、死亡率分别为41.9%(18/43)、16.3%(7/43);观察组治愈率、死亡率分别为83.3%(35/42)、2.4%(1/42),观察组治愈率远高于对照组,而死亡率明显低于对照组,比较两组有统计学意义(P0.01));观察组病情逆转率分别为4.8%(2/42)亦低于对照组的18.6%(8/43),P0.05。观察组不同病程分组比较并发症及治愈率,病程3年内明显优于3-6年及6年以上(P0.01);病程3-6年优于6年以上(P0.05)。结论对确诊NTM肺病,经药物治疗6个月以上,治疗效果不理想且病变局限的患者,可考虑手术切除病肺,早期手术治疗效果优于晚期手术治疗。
[Abstract]:Objective to investigate the therapeutic effect and opportunity of surgical treatment for nontuberculous Mycobacterium tuberculosis (NTM) pulmonary disease, and to provide evidence based medical evidence for optimizing the treatment regimen of NTM (nontuberculous Mycobacterium tuberculosis) pulmonary disease. Methods Eighty-five patients with NTM lung disease diagnosed in cardiothoracic surgery from October 2008 to March 2014 in Wuhan were randomly selected by digital table method. 42 cases (male 28, female 14, age 36.6 卤1.0) in the observation group were treated with surgical treatment. 43 patients in control group (male 29, female 14, age 33.4 卤1.5) were treated for more than 18 months according to the drug sensitivity results, followed up for 24 months, and the cure rate of the two groups was observed and compared. The number of patients with no change (rate, rate of reversal, mortality), and the cure rate and complication rate of patients with different course of disease in the observation group were compared. Results the cure rate and mortality rate of the control group were 41.9 / 43 / 16.3 / 7 / 43 respectively; the cure rate and mortality rate of the observation group were 83.33 / 35 / 42 / 42 respectively. The cure rate of the observation group was much higher than that of the control group, but the mortality rate was significantly lower than that of the control group. The reverse rate of disease in the observation group was 4. 8% and 42 / 42 respectively, which was also lower than that in the control group (18. 6 / 8 / 43 / P0. 05), and there was significant difference between the two groups (P 0. 01, P 0. 01, P 0. 05, P 0. 05). In the observation group, the complications and the cure rate were compared among different disease course groups. The course of disease in 3 years was better than that in 3 6 years and more than 6 years (P 0. 01), and the course of disease in 3 6 years was better than that in 6 years (P 0 05). Conclusion for the patients with NTM pulmonary disease who have been treated with drugs for more than 6 months and the effect is not satisfactory and the lesion is limited, surgical resection of the lung can be considered, and the effect of early surgical treatment is better than that of late surgical treatment.
【作者单位】：武汉市医疗救治中心胸外科;
【分类号】：R655.3

【相似文献】