Effects of different courses of chemotherapy for patients with solitary pulmonary tuberculoma after thoracoscopic resection
HE Ren-zhong1, ZHANG Jian-yong1, LIU Mei1, SONG Yong-xiang2, CHEN Ling1
1.Tuberculosis Division of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, China; 2. Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyin, Guizhou 563003, China
Abstract:The effects of different courses of chemotherapy for patients with solitary pulmonary tuberculoma after thoracoscopic resection were investigated for selecting reasonable courses of chemotherapy. After video-assisted thoracoscopic lung wedge resection, the patients with solitary pulmonary tuberculoma by histopathology diagnosis were collected from May 2007 to May 2017. These patients were continually accepted tuberculosis chemotherapy for following 2~12 months in the tuberculosis clinic of our hospital. Through 24 months continuous observation, the cure rate, relapse rate, incidence rate of adverse drug reactions and medication compliance rate of the patients were analyzed in different chemotherapy courses, retrospectively. Here, a total of 125 cases with solitarypulmonary tuberculoma undergoing anti-tuberculosis chemotherapy after thoracoscopic resection were reported. Firstly, the cure rate of all 125 patients with different chemotherapy courses was 100% with no relapse (Relapse rate was 0%). Secondly, the incidence rate of adverse drug reactions was 44.80% (25.00%~60.00%). The incidence rate of adverse reactions of patients in 2, 3 and 4 months were 60.00%, 25.00% and 25.00%, respectively. The lowest incidence rate of adverse drug reactions for patients with 3 and 4 months course (25.00%) was found. The incidence rate was increased along with the prolongation of treatment course. Thirdly, the medication compliance rate was 62.40% (38.46%~83.33%). The compliance rate of patients in 2, 3 and 4 months were 80.00%, 83.33% and 62.50%, respectively. The compliance rate was decreased along with the prolongation of treatment course. Additionally, the highest compliance rate was observed in the patients with 3 months course (83.33%). There were no statistically significant differences in the incidence rate and compliance rate among three chemotherapy courses (P>0.05). The main common adverse drug reactions were gastrointestinal reactions (26.40%), anti-tuberculosis drug-induced liver injury (20.80%) and urinary system abnormality(15.63%). The incidence rates of patients aged between 18~40, 41~60 and 61~70 were 33.33%, 41.38% and 59.46%, respectively. The incidence rate(59.46%)of patients aged 61~70 was higher than that(33.33%)of patients aged 18~40. There was statistically significant difference (P<0.05). The incidence rate of male patients was 50.00% and that of female patients was 37.25%. There was no statistically significant difference (P>0.05). In conclusion, for patients with solitary pulmonary tuberculoma after thoracoscopic resection, the effect of 3-month chemotherapy course was equivalent to other chemotherapy courses, with lower incidence rate of adverse drug reactions, and higher medication compliance comparing to other chemotherapy courses. Therefore, 3-month could be the best course of chemotherapy. The main common adverse reactions are gastrointestinal reactions, liver injury and urinary system abnormalities. In elder patients, the occurrence of adverse reactions should be paid more attention.
贺仁忠, 张建勇, 刘梅, 宋永祥, 陈玲. 孤立性肺结核球患者胸腔镜术后化疗不同疗程效果分析[J]. 中国人兽共患病学报, 2019, 35(9): 881-886.
HE Ren-zhong, ZHANG Jian-yong, LIU Mei, SONG Yong-xiang, CHEN Ling. Effects of different courses of chemotherapy for patients with solitary pulmonary tuberculoma after thoracoscopic resection. Chinese Journal of Zoonoses, 2019, 35(9): 881-886.