单纯结核性渗出性胸膜炎6月短程化疗的疗效分析

目的　了解初治单纯结核性渗出性胸膜炎 6月短程化疗效果,并探讨疗程。方法 回顾分析北京市 1996—2000年 9个区县结核病防治所符合选例标准的 256例单纯结核性渗出性胸膜炎 6月短程化疗的近、远期疗效。结果 治疗 6月末胸液完全吸收率为 73.0%(187/256)；随访 48月,2例复发,复发率 1.4%(2/139)。未完全吸收病例继续化疗至 9～12月,48月复发 2例,复发率 2.2%(2/92)。有症状至就诊时间 28d和＞28d病例 6月胸液明显吸收率分别为 87.1%(196/225)和67.7%(21/31)。无明显胸膜增厚率分别为 54.7%(123/225)和 32 .3%(10/31),两者有显著性差别。结论 单纯结核性渗出性胸膜炎采用 6月标准短程化疗方案,近、远期效果良好；对 6月末胸液尚未完全吸收的病人可适当延长疗程至 9～12月；早期诊断、早期治疗有利于胸液吸收和减少胸膜增厚。

The clinical outcome of 6-month short-course chemotherapy on pure effusive tuberculous pleurisy

Objective To determine the therapeutic effect of 6-month short-course chemotherapy of pure effusive tuberculous pleurisy,and to evaluate the period of treatment.Methods 256 cases of new pure effusive tuberculous pleurisy diagnosed and treated from 1996 to 2000 in 9 counties (distriats) TB Dispensaries in Beijing were reviewed and analyzed retrospectively.Results The rate of pleural effusion absorbed completely was 73.0% (187/256) at the end of 6-month.The cases were followed up 48 months and the relapse rate was 1.4%(2/139).The cases of pleural effusion not absorbed entirely continue received their treatment to 9～12 months,the relapse rate of following up 48 months was 2.2% (2/92).The patients with the duration between illness and clinical consultation ≤28 days or＞28 days,the rate of pleural effusion absorbed evidently were 87.1%(196/225)、67.7%(21/31) respectively at the end of 6-month.The rate of pleural not thickening were 54.7%(123/225)、32.3%(10/31) respectively,both rates were statistically significantly different.Conclusion The outcome of pure effusive tuberculous pleurisy used 6-month,the patients of pleural effusion not absorbed entirely could take their chemotherapy to 9～12 months.The early diagnosis and treatment were of benefit to the absorbing of pleural effusion and the reduction of pleural thickening.