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Journal of the Korean Academy of Family Medicine 1991;12(1):71-79.
Published online January 1, 1991.
Results of retreatment chemotherapy for intractable pulmonarytuberculosis patients.
Young Lae Lee, Kwang Seung Kim, Jae Ho Lee, Seung Guen Bae, Seun Keu Kim
난치성 결핵 환자의 치료성적에 관한 조사
김선규, 이영래, 김광성, 이재호, 배성근
부천제일병원 가정의학과
Abstract
A clinical study was performed on 67 cases of pulmonary tuberculosis patients who were treated as intractable patients at Inchon Red Cross Tuberculosis Sanatorium in past 18 months, from July 1987 through December 1988.
1. Intractable patients occupied 27.3% of total inpatients.
2. The ratio of male to female was 56.7% vs 43.3% and 51% of patients were the group between second and third decades.
3. Patients who have disease period over 3 years was 77.6% of patients have the disease for have than 3 years.
4. 64.2% was administrated the anti-tuberculosis drugs from 6 months to 2 years.
6. Kinds of drugs which were used before admission were reviewed as follows : INH 100%, EMB 82%, RFP 82%, SM 39.7%, PAS 42.6%, PZA 39.3%, KM 29.9%, PTA 26.4%, CS 19.7%.
7. Drug resistance rate were 86.2% to INH, 75.9% to RFP, 55.1% to EMB, 46.5% to SM, 31.0% to PAS, 27.6% to KM, 39.6% to PTA 24.1% to CS.
8. Resistance rate to more the 5 drugs 33.7% of patients showed resistance to more than 5 drugs.
9. Bacteriologic examination of sputum presented improvement in 54.7%(35/67), 72% of these patients changed into negative conversion from 2 months to 6 months after chemotherapy.
10. Chest X-ray on admission showed minimal pulmonary tuberculosis(Tb) or degree in 4.5%, moderate pulmonary Tb in 22.4%, far advanced pulmonary Tb in 73.1%.
11. Chest X-ray changes after chemotherapy showed mild improvement in 35.8%, moderate improvement in 19.4%, no change in 35.8%, aggravation in 7.5%.
Intractable tuberculosis due to initial resistant infection and acquired resistance was major source of disease transmission and increasing resistance of recent short-course drugs of chemotherapy were problem of tuberculosis management. In primary care family physician, proper and active management was necessary for improvement of intractable tuberculosis control in our country, in the medical, social and personal aspects in initial treatment.


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