摘要
目的 观察莫西沙星早期强化治疗结核性胸膜炎的临床效果.方法 选取毕节市某人民医院感染科收治的初治结核性胸膜炎患者88 例,随机分成观察组(n=44)和对照组(n=44),对照组应用异烟肼、利福平、吡嗪酰胺、乙胺丁醇等常规抗结核药物,以及胸腔穿刺引流等常规治疗,观察组在常规治疗的基础上使用莫西沙星早期强化治疗两周,观察并比较两组患者治疗后胸腔积液吸收情况,胸膜粘连肥厚情况,临床治疗效果以及药物不良反应情况.结果 所有患者临床随访观察1-6 个月,观察组治疗1 个月后胸腔积液完全吸收38 例,平均吸收时间为(19.35±2.16)d,对照组治疗1 个月后胸腔积液完全吸收26 例,平均吸收时间为(26.17±3.08)d,两组平均吸收时间相比差异有统计学意义(t=3.245,P=0.037);治疗6 个月后观察组胸膜粘连增厚3 例(6.8%)少于对照组的11 例(27.5%),差异有统计学意义(χ^2=6.453,P=0.011);观察组临床治疗有效40 例(90.9%),高于对照组33例(82.5%),差异无统计学意义;观察组药物不良反应8 例(18.2%),与对照组7 例(15.9%)比较,差异无统计学意义.结论 莫西沙星早期强化治疗结核性胸膜炎能够促进胸腔积液的早期吸收,减轻胸膜粘连和肥厚,无明显增加抗结核药物的不良反应.
Objective To investigate the clinical effect of moxifloxacin on the early and intensive treatment of tuberculouspleurisy. Methods 88 cases of patients with tuberculous pleurisy from the department of infectious disease in a people’s hospital of Bijiecity, were randomly divided into two groups observation group (n=44) and control group (n=44). The patients in control group were treated byconventional oral anti-TB drugs, such as isoniazid, rifampicin, pyrazinamide, ethambutol, etc. and pleural puncture fluid therapy, while thosein the observation group were given early and intensive treatment of moxifloxacin in two weeks, which was based on the conventional treatment.The clinical symptoms, adverse drug reactions, the absorption of pleural effusion, reduce pleural adhesion and hypertrophy were observedand compared between the two groups. Results All patients were followed up for 1-6 months. There was a total of 38 cases of completeabsorption in the observation group, the mean absorption time of pleural effusion was (19.35±2.16) d, and those in the control group was26 cases and (26.17±3.08) d, respectively, and there was a significant difference between two groups (t=3.245, P=0.037) . The incidence ofpleural thickening and adhesion in observation group (n=3) was lower than that in the control group (n=11), and the difference was statisticallysignificant (χ 2=6.453, P=0.011). 40 cases in the observation group with effective clinical treatment outcome, which was higher than 33 casesin the control group, the difference was not statistically significant. 8 cases in observation groups with adverse drug reaction, and 7 cases in thecontrol group, the difference was not statistically significant. Conclusions Early and intensive treatment with moxifloxacin on tuberculouspleurisy can improve the early absorption of pleural effusion and reduce pleural adhesion and hypertrophy, and do not obviously increaseadverse drug reaction.
出处
《中华灾害救援医学》
2016年第9期501-503,507,共4页
Chinese Journal of Disaster Medicine
关键词
莫西沙星
肺结核
胸膜炎
一线抗结核药物
moxifloxacin
tuberculous
exudative pleurisy
first-line anti-TB drugs