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纸质出版:2009
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秦世炳,董伟杰,徐双铮.脊柱结核药物治疗回顾性分析[J].陆军军医大学学报(原第三军医大学学报),2009,31(20):1929-1931.
QIN Shi-bing,DONG Wei-jie,XU Shuang-zheng.Chemotherapy in treatment of spinal tuberculosis: a retrospective analysis of 890 cases[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(20):1929-1931.
目的 探讨脊柱结核患者的药物治疗方案及时间,以分析确定脊柱结核的最佳结核药物的治疗方案及最佳用药时间。 方法 回顾性分析我院收治的890例脊柱结核住院患者的药物治疗方案和用药时间,针对不同的发病、临床表现、及其不同的手术效果分析其对抗结核药物干扰的影响,同时对初治、复治、复发及耐药的患者的治疗方案的应用,还有合并他处结核或合并其他疾病的个性化治疗方案的总结。 结果 890例脊柱结核中初治596例(67%),复治294例(占33%);其中收治的复发病例110例(占12.3%),耐药74例(8.3%);合并他处结核的273例(占30.7%)治疗方案以五联为主(H12/R12/E9/Z5/S3);复治的以添加二线及左氧氟沙星为主;耐药的以二线及静脉输注抗结核药物等,并根据耐药谱应用个性化治疗或随时更换抗结核药物方案,用药时间9~36个月不等,患者均痊愈。 结论 脊柱结核是结核分枝杆菌感染引起的脊柱骨感染性破坏,结核菌破坏力强,难杀灭,用药时间长,易形成医源性耐药,因此正确的抗结核药物治疗是治愈结核的关键,有效和规范抗结核菌药物治疗方案,对于脊柱结核的治疗有着重要意义。
Objective To analyze the drug therapeutic regimen and duration of the chemotherapy in the spinal tuberculosis in order to determine the best therapeutic regimen and duration of the spinal anti-tuberculosis. Methods The medication plan and duration of 890 hospitalized patients with spinal tuberculosis in our hospital from January 2001 to December 2008 were retrospectively investigated. We collected the plan of the initial treatment
retreatment
recrudescence and drug resistance. We also studied the individuation therapeutic regimen of the patients with tuberculosis at other parts or complications. On the basis of these data
we analyzed the interferential appearance that the anti-tuberculosis drug acted on different onsets
manifestations and operations. Results In 890 patients of spinal tuberculosis
596 cases (67%) were initial treatment
294 (33%) were retreatment
recur cases were 110 (12.3%)
drug resistance cases were 74(8.3%)
and those complicated with tuberculosis in other parts were 273 (30.7%). The main chemotherapeutic regimen was the usual tetragenous protocol (H12/R12/E9/Z5/S3). The retreatment cases were given second-line drugs such as levofloxacin. The drug resistance cases were also given second-line drugs and intravenous infusion. According to the anti-tubercle bacillus spectrum
individuation treatments were adopted
and the plan was changed in time. The medication duration continued for 9-36 months. All the 890 patients were cured. Conclusion For the treatment of spinal tuberculosis
it is significance to make a efficient and standardized anti-tuberculosis chemotherapy.
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