遵义医科大学学报2026，Vol.49Issue(5)：545-551,7.
规范化疗联合手术治疗对利福平耐药/耐多药肺结核患者的疗效及影响因素分析
Efficacy and influencing factors of standardized chemotherapy combined with surgical treatment in patients with rifampicin-resistant and multidrug-resistant pulmonary tuberculosis
摘要
Abstract
Objective This study aimed to investigate the impact of adjunctive surgical treatment,in addition to standardized chemotherapy,on the prognosis of patients with rifampicin-resistant or multidrug-resistant pulmonary tuberculosis.Methods A retrospective cohort study was conducted to analyze the clinical data of 107 patients hospitalized at the Beijing Chest Hospital,Capital Medical University,between 2014 and 2024.The therapeutic effects of pulmonary surgery combined with conventional chemotherapy(surgical group)were compared with those of chemotherapy alone(non-surgical group).Multivariable analysis was performed to identify factors influ-encing adverse outcomes.Results The cure rate and favorable outcome rate in the surgical group were 67.3％and 84.6％,respectively,compared to 56.4％and 70.9％in the non-surgical group.Although these differ-ences did not reach statistical significance(P=0.090),the treatment failure rate in the surgical group was sig-nificantly lower than that in the non-surgical group(5.8％vs 21.8％,P=0.018).Multivariable logistic analy-sis showed that the cumulative number of involved lung lobes was a significant factor affecting adverse outcomes(P=0.048,OR=1.366),suggesting that the risk of an adverse outcome increases by 36.6％for each addi-tional involved lung lobe.Conclusion This study indicates that surgery may have potential advantages in impro-ving the prognosis of patients with rifampicin/multidrug-resistant tuberculosis.However,further research is re-quired to optimize treatment strategies and improve cure rates and quality of life.关键词
肺结核/耐多药/手术治疗/化学治疗/治疗效果Key words
pulmonary tuberculosis/multidrug-resistance/surgical treatment/chemotherapy/therapeutic effect分类
医药卫生引用本文复制引用
李有才,杨丹,荆玮,初乃惠,聂文娟,王敬..规范化疗联合手术治疗对利福平耐药/耐多药肺结核患者的疗效及影响因素分析[J].遵义医科大学学报,2026,49(5):545-551,7.基金项目
国家重点研发计划项目(NO:2024YFC2311203) （NO:2024YFC2311203）
广州国家实验室2024年专项—结核病短程治疗项目(NO:GZNL2024A01030). （NO:GZNL2024A01030）
