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Objective To study the effect of drug combined with psychological intervention on mental status and quality of life in patients with multi drug resistant pulmonary tuberculosis.MethodsIn Jiashan Second People's Hospital from January 2011 to December 2016 were 100 cases of multi drug resistant tuberculosis patients as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.Patients in the control group were given routine drug treatment, and the patients in the experimental group were treated with psychological intervention on the basis of drug treatment.Comparison of the experimental group and the control group after 12 months of treatment, depression score and quality of life score.ResultsBefore treatment, there was no significant difference between the experimental group and the control group in the scores of life quality and the scores of depression and anxiety, which was not statistically significant.After treatment in December, the anxiety score of the patients in the experimental group was (41.2±8.2), and the score of depression was (36.4±4.5).The total score of quality of life was (75.2±11.2).The anxiety score of the control group was (52.3±7.4), and the score of depression was (45.4±5.6).The total score of QOL was (64.2±9.3).Thus, after the corresponding treatment, the experimental group of patients with depression and anxiety scores were significantly lower than those in the control group, the quality of life scores of the control group was significantly lower than the experimental group, with statistical difference (P<0.05).ConclusionThe drug combined with psychological intervention in treatment of multi drug resistant pulmonary tuberculosis can improve the therapeutic effect to a great extent, help the patients to relieve anxiety and depression and other negative emotions, improve the quality of life, with further clinical promotion and application significance.
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Objective To observe the effect of the compound Qinbudan recipe in treating multi-drug resistant pulmonary tuberculosis (MDR-PTB) of deficiency of both qi and yin. Methods A randomized controlled trial was carried out in 72 MDR-PTB cases, and the patients were divided into treatment group and control group, 36 cases in each group. The treatment group was treated with the compound Qinbudan recipe while the control group was treated with Feitai capsules. After treatment for 3 months, the therapeutic effect, scores of traditional Chinese medical syndromes, and adverse reactions were compared in the two groups. Results ( 1) After treatment for 3 months, the total effective rate of the treatment group was 82.86%, and that of the control group was 25.81%, the difference being significant (P 0.05) . ( 4) Blood routine examination and hepatorenal function showed no disorders during the treatment. Gastrointestinal disturbance was not found either. Conclusion The compound Qinbudan recipe is effective in treating multi-drug resistant pulmonary tuberculosis of deficiency of both qi and yin, and has better effect on relieving shortness of breath, night sweating, spontaneous perspiration and cough with phlegm than Feitai capsules .
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OBJECTIVE To analyze th antibiotic resistance features of Pseudomonas aeruginosa clinical isolates among patients with multi-drug resistant pulmonary tuberculosis,and the mechanism of resistance to imipenem.METHODS VITEK-32 automatic microbial identification system was used for microbial identification and sensitivity analysis.The clinic data of 93 cases of multi-drug resistance pulmonary tuberculosis with infection induced by P.aeruginosa from Jan 2006 to Oct 2007 in our hospital were analyzed.RESULTS Ninty-three P.aeruginosa strains had higher sensitive rate to carbapenem(87.2%),?-lactamase inhibitors(57.1-85.3%),aminoglycosides(53.7-75.0%),the fourth generation cephalosporins(50.3%) and quinolones(64.1-70.3%) but had higher resistance rate to the second-generation and third-generation cephalosporins(59.5-82.5%),furans(87.0%) and sulfonamides(83.8%).CONCLUSIONS Multi-drug resistant pulmonary tuberculosis with infection of P.aeruginosa should be paid close attention to,through reducing the use of enzyme inhibitors in the treatment,especially for patients with severe multi-drug resistant pulmonary tuberculosis,and avoid the inducing agent producing and prevent the plasmid dissemination and cross-infection.
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BACKGROUND: Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. MATERIAL AND METHOD: A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. RESULTS: The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. CONCLUSION: There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.
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Female , Humans , Male , Drug Therapy , Empyema , Fistula , Hemorrhage , Hope , Incidence , Mastectomy, Segmental , Postoperative Complications , Pulmonary Atelectasis , Retrospective Studies , Sputum , Thorax , Tuberculosis, Multidrug-Resistant , Tuberculosis, Pulmonary , Wound InfectionABSTRACT
OBJECTIVE:To evaluate the cost-effectiveness of two therapeutic schemes for treatment of multi-drug resistant pulmonary tuberculosis.METHODS:80 multi-drug resistant pulmonary tuberculosis patients were randomly assigned to receive Sparfloxacine(trial group)or Ofloxacin(control group)plus anti-TB drugs(Rifapentine,Pyrazinamide,Sodium Aminosalicylate.Protionamide and Ethambatol)for 12 months.The curative effects and adverse drug reactions were monitored and the cost-effectiveness analyses were conducted.RESULTS:The costs in two groups(Sparfloxacin vs.Ofloxacin)were 10 143.25 and 7 841.65yuan,respectively;the negative-conversion rates of sputum bacteria after treatment for 12 months were 90.0% and 70.0%,respectively(P
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BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.
Subject(s)
Humans , Follow-Up Studies , Isoniazid , Lung , Mortality , Pneumonia , Retrospective Studies , Rifampin , Sputum , Tuberculosis, PulmonaryABSTRACT
BACKGROUND: Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.