摘要
目的对化疗联合经皮超声电导抗结核药物治疗早期膝关节结核的疗效进行评价。方法搜集2010年1月至2015年7月首都医科大学附属北京胸科医院门诊及住院治疗的膝关节结核患者64例，采用前瞻性队列研究设计，按照抽签随机对照原则：化疗联合经皮超声电导抗结核药物治疗组（简称“联合治疗组”）29例，其中男16例，女13例，年龄18～61岁，平均（37．15±13．39）岁；单纯口服抗结核药物化疗组（简称“单纯化疗组”）。35例，其中男20例，女15例，年龄17～65岁，平均（36．45±12．30）岁。患者在治疗前后分别进行CT及MRI检查，以了解关节结核的病变治疗情况；以及比较患者治疗前后的美国特种外科医院膝关节评分（hospital for special surgery knee sore，简称“HSS评分”）结果。对上述两组的年龄、患病月数、治疗前后的HSS评分进行t检验，性别采用四格表检验，有效率采用秩和检验，以P〈0．05为差异有统计学意义。结果两组在治疗前的性别（X2=0．238，P=0．722）、年龄（t=0．352，P=0．637）、患病月数（t=0．486，P=0．138）及联合治疗组患者治疗前的HSS评分为（73．53±6．70）分，单纯化疗组为（61．37±10．35）分（t=0．859，P=0．768），差异均无统计学意义。而治疗后联合治疗组的有效率为79．3％（23／29），优于单纯化疗组的68．6％（24／35）（Z=87．32，P=0．037）。联合治疗组患者HSS评分治疗后的（73．53±6．70）分，而单纯化疗组为（61．37±10．35）分（t=2．397，P=0．020），联合治疗组的治疗效果优于单纯化疗组。结论联合治疗组较单纯化疗组治疗效果好，值得推广应用。
Objective To evaluate efficacy of early knee joint tuberculosis treated by chemotherapy combined with percutaneous ultrasonic conductometric targeted anti-tuberculosis drugs. Methods A prospective cohort study was conducted in 64 outpatients and inpatients with knee joint tuberculosis in our hospital during Jan. 2010 to Jul. 2015. All patients were divided randomly into group of chemotherapy combined with percutaneous ultrasonic conductometric targeted anti-tuberculosis drugs （the combined treatment group ： 29 cases, 16 males and 13 females, average age 37.15 ± 13.29 ranged from18 - 61） and group of chemotherapy taken only oral anti-tuberculosis drugs （the chemotherapy group： 35 cases, 20 males and 15 females, average age 36.45 ± 12.30 ranged from 17-65）. CT and MRI were performed to evaluate the condition of knee joint tuberculosis before and after treatment. The scores were also compared using American Hospital for Special Surgery Knee Score （HSS） before and after treatment. Age, course of disease, HSS scores were analyzed by t test, gender by Chi square test and the effective rates by rank sum test. P〈0.05 was considered significant difference. Results Gender （X2 = 0.238, P=0.722）, age （t= 0.352, P=0.637）, course of disease （t=0.486, P = 0.138） and HSS （t=0.859, P=0.768） were not difference statistically in two groups before treatment. The effective rate （79.3%, 23/29） in the combined treatment group was better than that （68.6%, 24/35） in the chemotherapy group after treatment （X2=87.32, P=0.037）. The HSS score （73.53 ± 6.70） in the combined treatment group was higher than that （61.37 ± 10.35） in the chemotherapy group （ t =2.397, P=0.020）. Conclusion The efficacy in combined treatment group is better than that in chemotherapy group. The model of chemotherapy combined with pereutaneous ultrasonic conductometric targeted anti-tuberculosis drugs is worthy to be popularized and applied in the future.
出处
《结核病与胸部肿瘤》
2017年第1期33-36,共4页
Tuberculosis and Thoracic Tumor
关键词
结核
膝关节
超声电导
药物疗法
比较研究
Tuberculosis, knee joint
Ultrasonic conductometric
Pharmacotherapy
Comparative study
