肺结核患者早期终止治疗对其疗效的影响

Shurygin A.A., M. E.A.
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摘要

化疗疗程的有效性很大程度上取决于疗程的连续性和持续时间。一个疗程化疗的无效结果,除了客观原因外,还有一个因素加强了它——治疗中断或早期终止。本研究旨在探讨早期终止化疗对保留病原菌药敏的肺结核患者的治疗效果。材料和方法:回顾性分析了在彼尔姆地区注册的1-2-3化疗方案中过早中断治疗的结核病患者的化疗过程的结果。结果:采用1-2-3化疗方案的患者中有7.8%出现治疗中断或早期终止。在住院治疗阶段,在1-2-3化疗方案强化阶段接受治疗的患者中有3.5%与治疗分离。在1-2-3化疗方案的继续阶段接受治疗的患者中,有7.9%的患者在门诊阶段与治疗分离,这些术语不足以用于整个化疗过程。间歇性治疗的另一个不利因素是结核分枝杆菌继发性耐药的形成。化疗过程的无效导致结核病患者人数的增加和疫情的紧张。结论:彼尔姆地区药物敏感性结核病患者在治疗中,门诊阶段中断治疗的频率高于住院阶段(p=0.03),预防早期终止治疗的原因有待进一步研究。结果发现,所有患者均因过早终止治疗导致CT无效。社会因素(缺乏收入、不利的生活条件和远离药房、配备合格的医务人员)会影响治疗的坚持性和有效性。
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INFLUENCE OF EARLY TERMINATION OF TREATMENT OF PATIENTS WITH TUBERCULOSIS ON ITS EFFECTIVENESS
The effectiveness of a course of chemotherapy largely depends on the continuity and duration. An ineffective outcome of a course of chemotherapy, in addition to objective reasons, also has an additional factor that strengthens it – a break in treatment or its early termination. The aim of the work is to study the effectiveness of treatment of patients with pulmonary tuberculosis with preserved drug sensitivity of the pathogen with early termination of the course of chemotherapy. Materials and methods: A retrospective analysis of the outcomes of a course of chemotherapy of tuberculosis patients who prematurely interrupted treatment, registered for 1-2-3 chemotherapy regimens in the Perm Region, was carried out. Results: Interruptions in treatment or its early termination were present in 7.8% of patients registered for treatment with 1-2-3 chemotherapy regimens. At the stage of inpatient treatment, there is a separation from treatment in 3.5% of patients receiving treatment in the intensive phase of 1-2-3 chemotherapy regimens. Separation from treatment at the outpatient stage is noted in 7.9% of patients receiving treatment in the continuation phase of 1-2-3 chemotherapy regimens, these terms are insufficient for a full course of chemotherapy.. An additional unfavorable factor of intermittent treatment is the formation of secondary drug resistance of Mycobacterium tuberculosis. The ineffectiveness of the course of chemotherapy leads to an increase in the number of patients with tuberculosis and the tension of the epidemic situation. Conclusions: In the treatment of patients with drug-sensitive tuberculosis in the Perm Region, treatment is interrupted more often at the outpatient stage than at the inpatient stage (p=0.03), which requires further study of the reasons for preventing early termination of treatment. It was found that the termination of treatment prematurely in all patients led to the ineffectiveness of CT. Social factors (lack of income, unfavorable living conditions and distance from drug dispensaries, staffing of qualified medical personnel) can affect the adherence and effectiveness of treatment.
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