潍坊市第二人民医院住院肺结核患者耐药情况分析

目的 了解我院肺结核患者耐药情况，探讨耐药肺结核形的原因。方法 调查2000年1月至2003年1月在我院住院的痰结核菌培养阳性患者，并对5种抗结核药物率(INH、RFP、PZA、PAS)进行耐药测试。19．9％，获得性耐药率78．67％。结论 耐药率为农村高于城市，青年高于中年，中年高于老年。应加强对农村及青壮年结核患者的管理。     

氧驱动雾化吸入异烟肼加利福霉素治疗复治菌阳肺结核的临床研究

目的观察氧驱动雾化吸入异烟肼加利福霉素治疗复治菌阳肺结核的疗效与安全性。方法治疗组60例要求无咯血患者,在传统抗结核药物治疗基础上加入异烟肼0.1g+利福霉素0.125g雾化吸入,1次/d,每次20min,雾化时间1～2个月。对照组:50例给予传统抗结核治疗。观察两组患者的总有效率,并对低热、乏力、痰结核菌、空洞等分别在治疗前及治疗后进行评价。结果观察半年,治疗组,显效55例,总有效率91.7%,对照组,显效38例,总有效率为76%,治疗组总有效率明显优于对照组,差异有统计学意义(P<0.05),治疗组治疗后病灶吸收情况优于对照组,差异有统计学意义(P<0.05),治疗组未出现明显不良反应。结论氧驱动雾化吸入异烟肼加利福霉素治疗复治菌阳肺结核,应用较为安全有效。     

Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P＜0.05, P＜0.05, P＜0.05 and P＜0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P＜0.01 and P＜0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.     

血清锌含量对脑梗死患者的临床意义

目的探讨血清锌含量对脑梗死患者的临床意义。方法选取48例脑梗死患者作为研究组,根据NIHSS评分和MRS分别给予评分;选取40例短暂性脑缺血发作者作为对照组,两组患者均抽取空腹血测定血清锌水平。结果脑梗死组锌平均含量为（0.68±0.29）mg/L,TIA组锌平均含量为（0.76±0.18）mg/L,脑梗死组低于短暂性脑缺血发作组（P〈0.05）。脑梗死预后差的患者中锌含量为（0.63±0.27）mg/L,而预后较好的患者锌含量（0.73±0.25）mg/L,预后差者低于预后较好者（P〈0.05）。NIHSS评分≤8和锌≤65mg/L与预后不良有关联（P〈0.05）。结论血清锌的降低与脑梗死预后密切相关,且能够较准确判定患者的预后及生存质量。     

血清锌含量对脑梗死患者的临床意义

目的探讨血清锌含量对脑梗死患者的临床意义。方法选取48例脑梗死患者作为研究组,根据NIHSS评分和MRS分别给予评分;选取40例短暂性脑缺血发作者作为对照组,两组患者均抽取空腹血测定血清锌水平。结果脑梗死组锌平均含量为(0.68±0.29)mg/L,TIA组锌平均含量为(0.76±0.18)mg/L,脑梗死组低于短暂性脑缺血发作组(P<0.05)。脑梗死预后差的患者中锌含量为(0.63±0.27)mg/L,而预后较好的患者锌含量(0.73±0.25)mg/L,预后差者低于预后较好者(P<0.05)。NIHSS评分≤8和锌≤65mg/L与预后不良有关联(P<0.05)。结论血清锌的降低与脑梗死预后密切相关,且能够较准确判定患者的预后及生存质量。     

含中药方案治疗糖尿病并初治涂阳肺结核的临床研究

目的观察和评价含中药方案治疗糖尿病并初治涂阳肺结核的近期疗效.方法将70例糖尿病并继发型初治涂阳肺结核患者随机分为治疗组(A组,38例)和对照组(B组,32例).年龄20～70岁.     

纤维支气管镜下给药治疗支气管内膜结核疗效观察（附2例报告）

支气管内膜结核是气管、支气管粘膜或粘膜下层的结核病变，易导致支气管狭窄及肺不张。我院对近期发现的2例支气管内膜结核病人支气管镜下给药：异烟肼0．1 利福霉素0．125，并配以雾化吸人治疗，取得了满意效果，报告如下。     

结核性胸膜炎180例临床分析

目的总结结核性胸膜炎的临床特点并探讨治疗方法。方法选自2000年1月至2004年12月住院并资料完整的结核性胸膜炎患者180例,采用回顾性分析。结果180例中青年占大多数(86.1%),大多数具有典型的结核中毒症状。所选病例在积极抗结核治疗的同时尽早胸穿抽液,治愈69例(38.3%),胸膜肥厚76例(42.2%),包裹35例(19.5%),其预后与治疗的早晚密切相关。结论掌握结核性胸膜炎的临床特点,早期诊断,规范治疗,可取得良好疗效。     

活动期髋、膝关节结核一期人工关节置换术的远期疗效观察

目的探讨活动期髋、膝关节结核一期人工关节置换术的可行性,解决骨关节结核传统手术方法治疗造成的关节功能丧失,以及给患者带来的生活、工作上的不便和精神痛苦等问题。方法对18例活动期髋、膝关节结核的患者,在清除结核病灶的同时,行一期人工关节置换术。其中12例髋关节结核行人工全髋关节置换术,6例膝关节结核行人工膝关节表面置换术。结果 18例均痊愈,关节功能恢复良好,屈曲活动度达90～110°。1例全髋关节置换10年后因外伤出现患髋疼痛,复查X线片示髋臼松动移位。结论骨关节结核一期人工关节置换术是可行的。其成功与否,不在于病变破坏的程度轻重,关键在于结核病灶清除的彻底性。另外,严格掌握手术时机,规律、合理、有效地应用抗结核药物,是人工关节置换术的基本保证。