Clinical Study On Surgical Timing Of Surgical Treatment For Drug-resistant Tuberculosis

Objective: To provide a basis for choosing the surgery timing by comprehensively analyzing the factors affecting the postoperative complications and postoperative efficacy for surgical treatment of drug-resistant pulmonary tuberculosis.Method: A retrospective analysis of 55 patients undergoing pulmonary wedge resection and lobectomy for drug-resistant tuberculosis from January 2010 to January2017.Collect basic data of patients’ hospitalization(gender,age,weight,height,diagnosis and medical history data,etc.),as well as patient’s lesion location,types of anti-tuberculosis drugs before and after surgery,specific drugsand anti-TB treatment time,intraoperative and postoperative Relevant information,postoperative complications(pulmonary infection,incision infection,postoperative internal bleeding,postoperative pneumothorax,bronchopleural fistula,postoperative atelectasis)and postoperative efficacy,etc.Using spss16.0 software to analyze gender,age,body mass index,surgical method,location of lesions,type of drug resistance,anti-tuberculosis time before surgery,etc.,which may affect the incidence of postoperative complications and efficacy of surgical treatment of drug-resistant tuberculosis factor.Result:The age,gender and anti-tuberculosis time before operation of 55 patients with drug-resistant tuberculosis had no statistical significance on the difference of postoperative complications and postoperative efficacy(P>0.05),The postoperative complication rate of thoracoscopic surgery was lower than that of traditional thoracotomy surgery,with a statistically significant difference(P = 0.032 < 0.05),but there was no statistically significant difference in the postoperative efficacy(P = 0.449 >0.05).there was no statistically significant difference in BMI affecting the occurrence of postoperative complications(P = 0.099 > 0.05),but the postoperative cure rate of BMI≥18.5kg/m was higher than that of BMI < 18.5kg/m,and the difference was statistically significant(P = 0.035 < 0.05).Single drug resistant tuberculosis incidence of postoperative complications in patients with the multi-drug resistant/extensively drug-resistant low incidence of postoperative complications,was statistically significant(P = 0.027 > 0.05),and high cure rate,postoperative was statistically significant(P =0.034 < 0.05,on both sides unilateral P = 0.017 < 0.05),postoperative complications of single lung lesions involving the lesions involving much lower incidence of postoperative complications of lung,was statistically significant(P = 0.017 < 0.05),and high cure rate,postoperative was statistically significant(P = 0.041 < 0.05).Conclusion:1..Although the effect of preoperative drug chemotherapy time on the postoperative efficacy is not specific,according to domestic and foreign guidelines and literature,it is suggested that sputum bacteria should not turn negative during antituberculosis treatment for 3 to 6 months,that is,active surgical treatment,2.Thoracoscopic surgery is recommended for patients with indications for thoracoscopic surgery,3.Active surgery is recommended before the lesion is confined to one lobe and/or multidrug-resistant or extensively resistant develops.4.Patients’ high body mass index has a positive effect on the efficacy of surgical treatment for drug resistance.