肺结核患者治疗失败的原因分析及护理对策

目的分析肺结核患者治疗失败的原因，以便施予针对性的护理和治疗。方法回顾性分析近5年本院治疗肺结核失败116例患者的原因，并对其采用家庭访视，查阅病历，服药登记表及登记卡随访记录等方法进行调查。结果116例肺结核患者治疗失败的主要原因为：对自身疾病认识不足，不规范服药50例（43．1％）；合并糖尿病25例（21．55％）；耐药菌感染21例（18．1％）；药物反应不能服药11例（9．48％）；去向不明7例（6．05）；拒绝治疗2例（1．72％）。结论加强肺结核病防治知识和结核病控制项目的宣传力度，做好心理护理，建立“引导一合作型”的良好护患关系，积极治疗糖尿病，提高老年患者的服药依从性，并采用直接面视下的短程化疗和家庭监督等双重护理管理模式，从而达到控制肺结核的目的，提高患者治愈率。

Causes analysis and nursing countermeasures of treatment failure of pulmonary tuberculosis patients

Objective To analyze the cause of treatment failure of pulmonary tuberculosis patients; so as to give special nursing and treatment. Methods The causes of treatment failure of 116 pulmonary tuberculosis patients were retrospectively analyzed in recent 5 years in out hospital; the patients were investigated by family visit, reading medical records, taking medicine registration and checking follow-up records. Results Among 116 pulmonary tuberculosis patients, the main causes of treatment failure were： 50 （43.1% ） with insufficient understanding of their illness and non-compliance with antl-tuberculosis medications; 25 （21.55%） with diabetes; 21 （ 18.1% ） with resistant bacterial infection; 11 （9.48%） no taking medicine duo to drug reaction; 7 （6. 05% ） leaving hospital with no further contact; 2 （ 1.72% ） refused the treatment. Conclusion Strengthening the propaganda work of prevention and control of tuberculosis, doing well psychological nursing, establishing good nurse patients relationship with guidance-cooperation, actively treating diabetes, improving the drug compliance of elderly patients, directly using double nursing mode of short-course chemotherapy and family observation, thus achieved the aim to control the pulmonary tuberculosis and improve the cure rate of the patlents.