[监测药物剂量和治疗时间对公共卫生中心结核病患者管理的重要性]。

Kekkaku : [Tuberculosis] Pub Date : 2014-10-01
Kunihiko Ito, Keiko Fukuuchi, Sumi Kaguraoka, Hiroyuki Watanabe, Takashi Yoshiyama, Minako Urakawa, Youko Nagata
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引用次数: 0

摘要

目的:根据实际现场数据,探讨监测药物剂量和治疗时间对在公共卫生中心治疗的结核病患者的支持护理的重要性。患者与方法:对新宿区公共卫生中心登记的结核病患者主要抗结核药物用量及治疗时间进行分析。结果:新宿区公共卫生中心登记的结核病患者中,利福平和异烟肼按“推荐”剂量实际使用的比例分别为57.3%(67/117)和82.0%(114/139)。相比之下,在高度专业化的结核病医院接受治疗的结核病患者中,患病率分别为81.0%(98/121)和93.5% (86/92);对于这两种药物,这家医院的发病率明显高于新宿区公共卫生中心。在治疗时间方面,在新宿-宿公共卫生中心登记的92例可在标准时间内完成标准治疗的患者中,有15.2%的患者实际治疗时间短于标准时间(14/92;-32至-1天),77.2% (71/92;2至146天);后71例患者的总多余治疗天数为1877天。31例患者的治疗时间比标准时间短或长2周以上,其中71.0%(22/31)患者的治疗时间不标准的具体原因无法确定。结论:相当一部分患者用药剂量和治疗时间不符合标准值。通过使用这些数据来管理在公共卫生中心治疗的结核病患者的药物剂量和治疗时间,我们可以提高所提供的支持性护理的质量。
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[Importance of monitoring the drug dosage and treatment duration for the management of tuberculosis patients at public health centers].

Purpose: On the basis of actual field data, we investigated the importance of monitoring the drug dosage and treatment duration for the supportive care of patients with tuberculosis who were being treated at public health centers.

Patients & methods: Data of the drug dosage of principal anti-tuberculosis drugs and the treatment duration for the registered patients with tuberculosis at the Shinjuku-ku Public Health Center were analyzed.

Results: The actual dosage of rifampicin and isoniazid according to the "recommended" dosage was administered to 57.3% (67/117) and 82.0% (114/139), respectively, patients with tuberculosis registered at the Shinjuku-ku Public Health Center. In contrast, in patients with tuberculosis who were treated at a highly specialized tuberculosis hospital, the rates were 81.0% (98/121) and 93.5% (86/92), respectively; for both drugs, the rates were significantly higher in this hospital than in the Shinjuku-ku Public Health Center. For the treatment duration, of 92 patients registered at the Shinjuku-ku Public Health Center who could have completed standard treatment in the standard duration, the actual treatment durations were shorter than the standard duration in 15.2% of the patients (14/92; -32 to -1 days), and longer than the standard duration in 77.2% (71/92; 2 to 146 days); the total superfluous treatment days for the latter 71 patients were 1,877 days. The treatment durations were more than 2 weeks shorter or longer than the standard duration for 31 patients, and in 71.0% (22/31) of these patients, no specific reason could be determined as to why the treatment durations were not standard.

Conclusion: In a significant number of patients, the drug dosage and treatment duration were not according to the standard values. By using this data about the management of the drug dosage and treatment duration for the supportive care of patients with tuberculosis treated at public health centers, we may improve quality of the provided supportive care.

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