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患者女,18岁。因咳嗽、盗汗、发热2个月就诊。查体仅发现左肺呼吸音减低。ESR77mm/h,痰涂片结核杆菌(卅);X线胸片示左肺上、下野有小片状阴影,左中野有大片模糊阴影。诊断为左侧浸润型肺结核。采用短程间歇标准化疗方案治疗,即2H_3R_3Z_3S_3/4H_3R_3(H为异烟肼,R为利福平,Z为吡嗪酰胺,S为链霉素)。经2个月强化期治疗结束时,患者咳嗽减轻,痰量明显减少,但体温仍在37.3～38℃。复查ESR105mm/h;胸片示病灶进展,左肺中下野有大片阴影,痰菌阴转,考虑为“类赫氏”现象而延长强化期治疗1个月。6个月疗程结束时,病人情况好转,痰菌阴性,ESR降至40mm/h,但胸片示左肺融合为大片状阴
Patient female, 18 years old. Due to cough, night sweats, fever 2 months treatment. Physical examination found only reduced left lung breath sounds. ESR77mm / h, sputum smear Mycobacterium tuberculosis (卅); X-ray showed the left lung, the lower field has a small shadow, the left of the field has a large shadow of fuzzy. Diagnosis of left infiltrative pulmonary tuberculosis. The use of short interval intermittent standard chemotherapy regimen, namely 2H_3R_3Z_3S_3 / 4H_3R_3 (H is isoniazid, R is rifampin, Z is pyrazinamide, S is streptomycin). After 2 months of intensive treatment at the end of the patient to reduce cough, sputum volume decreased significantly, but the body temperature is still 37.3 ~ 38 ℃. Review ESR105mm / h; chest X-ray showed lesions progress, the left lung has a large shadow of the middle and lower lungs, sputum negative conversion, consider the “like Hatch” phenomenon and extend the intensive treatment for 1 month. At the end of the 6-month course of treatment, the patient’s condition improved, sputum negative, ESR dropped to 40mm / h, but the chest radiograph showed left lung fusion as a large piece of shade