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OA

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.