四川省中医院患者HIV感染的临床研究

发布时间：2018-04-04 12:46

本文选题：四川省中医院　切入点：患者　出处：《成都中医药大学》2013年硕士论文

【摘要】：目的：为了遏制艾滋病的增长态势,保护人民健康,减少医务人员的职业暴露风险,开展四川省中医院患者HIV感染的临床研究。方法：对四川省中医院2012年度检验科免疫室HIV抗体初筛试验阳性,且经成都市疾病预防控制中心进行确证试验的患者,依照现行纳入和排除标准进行筛选。并对HIV/AIDS住院病例进行回顾性分析。结果：2012年度四川省中医院HIV抗体初筛试验阳性患者60例,排除阴性、可疑阳性及资料不全者10例,纳入50例,男性43例,女性7例。包括门诊患者8例,住院患者42例。年龄最小18岁,最大86岁,中位年龄38.5岁。2012年度医院收治住院患者共计31809例,检出HIV/AIDS患者42例,检出比为0.13%。列入研究的科室23个,检出HIV/AIDS患者1例以上的科室17个,占65.4%。这17个科室收治住院患者共计25060例,检出HIV/AIDS患者42例,检出比为0.17%。检出病例数前五位的科室为肛肠科(7例)、皮肤科(5例)、泌尿外科(4例)、急诊科(4例)、呼吸科(3例)。检出百分比前五位的科室则为皮肤科0.44%、泌尿外科0.35%、针灸科0.33%、肛肠科0.21%、急诊科0.20%。主要以皮肤斑丘疹,肛门肿物脱出,肛旁肿痛,咳嗽、咳痰、呼吸困难、腹泻、消瘦等症状就诊。入院诊断中以社区获得性肺炎,痔疮,带状疱疹,肛周脓肿常见。中医舌脉中,以色红,黄腻苔,滑数脉常见,实证居多。中医临床分期与西医临床分期比较,两者存在相关性(rk=0.773,P=0.000)。艾滋病期患者13例,以反复的细菌性肺炎、带状疱疹、反复腹泻、发热为入院诊断。HIV/AIDS患者中,45.2%合并有其他性传播疾病,梅毒常见。检出7种WB带型,p55、p17出现频率较低。肺部影像以广泛磨玻璃样改变及肺炎表现常见。结论：HIV/AIDS已经成为四川省中医院的常见病种之一。职业暴露的潜在危险日渐显露,但是医务人员对严峻的AIDS增长态势尚未引起足够的重视。加强AIDS防控知识教育已经迫在眉睫,而开展中医、中西医结合临床研究的历史机遇也已经来临。
[Abstract]:Objective: in order to control the increasing trend of AIDS, protect the health of the people and reduce the occupational exposure risk of medical personnel, the clinical study of HIV infection among patients in Sichuan traditional Chinese medicine hospital was carried out.Methods: the patients who were tested positive for HIV antibody in the immunological laboratory of Sichuan traditional Chinese Medicine Hospital in 2012 were screened according to the current criteria of inclusion and exclusion, which were confirmed by Chengdu Centers for Disease Control and Prevention.The inpatients with HIV/AIDS were analyzed retrospectively.Results among 60 patients with positive HIV antibody test in Sichuan traditional Chinese Medicine Hospital in 2012, 10 cases were excluded negative, suspicious positive and incomplete data, 50 cases were included, 43 cases were males and 7 cases were females.There were 8 outpatients and 42 inpatients.The median age was 38.5 years old. The median age was 38.5 years. A total of 31809 inpatients were admitted in the hospital in 2012. 42 cases of HIV/AIDS were detected, and the detection ratio was 0.13%.Of the 23 departments included in the study, 17 (65.4%) had more than one case of HIV/AIDS.A total of 25060 inpatients were admitted to these 17 departments, 42 cases of HIV/AIDS were detected, the detection ratio was 0.17%.In the first five departments, there were 7 cases of anal and intestinal diseases, 5 cases of dermatology, 4 cases of urology, 4 cases of emergency diagnosis and 3 cases of respiratory diseases.The first five departments were dermatology 0.44, urology 0.35, acupuncture 0.33, anorectal 0.21, emergency 0.20.Mainly with skin spot papules, anal tumor prolapse, perianal swelling, cough, expectoration, dyspnea, diarrhea, wasting and other symptoms.Community acquired pneumonia, hemorrhoids, herpes zoster and perianal abscess are common in admission diagnosis.In tongue vein of traditional Chinese medicine, color red, yellow greasy fur, smooth number of veins are common, empirical evidence is the majority.There was a correlation between the clinical stage of TCM and the clinical stage of western medicine.13 cases of AIDS were diagnosed by repeated bacterial pneumonia, herpes zoster, repeated diarrhea and fever. 45.2% of HIV / AIDS patients were diagnosed with other sexually transmitted diseases, syphilis was common.It was found that the frequency of p55 p17 was lower than that of 7 types of WB band type.Pulmonary imaging is common with extensive glass-like changes and pneumonia.Conclusion HIV / AIDS has become one of the most common diseases in Sichuan Provincial Hospital of traditional Chinese Medicine.The potential risks of occupational exposure are emerging, but medical staff have not paid enough attention to the grim growth of AIDS.It is urgent to strengthen the knowledge education of AIDS prevention and control, and the historical opportunity of developing TCM and integrating traditional Chinese medicine and western medicine has come.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.91

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