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研究难治性肺内、肺外结核的治疗,对肝功能异常者和不能耐受一线抗痨方案者及耐多药结核患者提出有效的治疗方案。采用乳酸左氧氟沙星,每晨5～6m g/kg 1 次顿服;帕司烟肼,每日15～20m g/kg 分2～3 次口服。根据病人具体情况加选下列药品中的1～2 种:卡那霉素,阿米卡星,乙胺丁醇,大蒜素,黄莲素,优福宁。对24 例患者采用以上方案治疗1 年以上,每阶段均做详细观察并记录。结果24 例患者有效19 例,显效4 例,进步1 例,有效率达95.8% 。疗程前结核菌阳性的肺结核均在用药1～2 个月内转阴,15 例治疗前肝功能异常者皆在改用本方案后2 个月内恢复正常。提示常规第一线抗结核药物除链霉素、乙胺丁醇外都易引起肝脏的损害,而本组24 例难治性结核经治疗初步获得了较好的疗效,此方案对肝脏损害作用小,杀菌效果可靠,初步获得了较好的近期效果。
To study the treatment of refractory intrapulmonary and extrapulmonary tuberculosis, the effective treatment of patients with abnormal liver function and can not tolerate first-line anti-tuberculosis program and MDR-TB patients. Levofloxacin lactate, morning 5 ~ 6m g / kg 1 Day service; parisulfate, daily 15 ~ 20m g / kg orally 2 to 3 times. According to the specific circumstances of the patient add the following drugs in the 1 to 2 kinds: kanamycin, amikacin, ethambutol, allicin, pristine, excellent Funing. 24 cases of patients with the above treatment for more than 1 year, each stage are carefully observed and recorded. Results Twenty-four patients were effective in 19 cases, markedly effective in 4 cases and advanced in 1 case, the effective rate was 95.8%. Mycobacterium tuberculosis-positive pulmonary tuberculosis before treatment were negative within 1 to 2 months of treatment, 15 cases of pre-treatment liver dysfunction were switched to the program within 2 months after the return to normal. Tip conventional first-line anti-TB drugs in addition to streptomycin, ethambutol easily lead to liver damage, and the group of 24 cases of refractory tuberculosis initially achieved good results, the program on liver damage Small, bactericidal effect is reliable, initially obtained better recent results.