124例涂阳肺结核复治失败原因分析

目的分析复治涂阳肺结核患者治疗失败的原因。方法收集1992～2000年海南省实施世界银行贷款结核病控制项目期间复治涂阳化疗失败病人完整病历124份，进行回顾性分析。结果124例中不规则治疗率为84．7％。实施复治涂阳方案治疗后，2月末痰阴转率35．5％、3月末痰阴转率20．0％、5月末痰阴转率29．8％，阳转率16．1％、8月末痰阳转率100％。结论对初治患者合理使用短程化疗，是防止造成复治、形成MDR—TB的关键；开展初始耐药率的监测，制定有效的治疗方案，对防止MDR产生有着重要的意义。

Analysis of causes of failure in retreatment of 124 smear positive tuberculosis patients

Objective To analyze the causes of re - treatment failure in smear- positive pulmonary tuberculosis. Methods Complete case history of 124 cases of smear - positive pulmonary tuberculosis was collected for analysis during the provincial project period from 1992 to 2000. Results 84.7% of the cases were irregularly treated. After of smear-positive re-treatment, 35.5% of the cases were sputum negative by the end of the 2nd month, 20.0% of sputum negative by the end of the 3rd month. By the end of the 5th month, the sputum negative rate was 29.8% with a positive rate of 16.1%. The sputum positive rate reached 100% by the end of the 8th month. Conclusion It is crucial to use short-term chemotherapy in early treatment for preventing the occllrrence of re-treatment and MDR - TB. It is of great importance to carry out primary surveillance of drug resistance and work out effective treatment in the prevention of MDR.