642例儿童结核病临床分析

发布时间：2018-08-22 18:09

【摘要】：目的：为加强对儿童结核病的认识，以尽量降低对儿童结核病的误诊、误治，改善儿童结核病治疗预后。方法：对2008.1.1-2011.12.31期间在我院住院的642例儿童结核病资料进行临床总结分析。结果：本组病例中男58.4%，女41.6%；农村（包括流动人口）83.3%，城市占16.7%；有卡介苗接种史68.1%，有明确结核病人接触史占21.5%，；642例中肺内结核占36.9%，肺外结核占27.9%，全身性结核病占33.8%，先天性结核病占1.4%；临床表现中，尽管千差万别，但儿童结合补丁中，具有不规则发热达55.5%，；血沉306例中增快占67.9%，PPD试验299例中，"g（++）占26.8%；605例做了血液分析结果中WBC10*109/L占46.3%，PLT300*109/L占65.8%，Hb110g/L占54.4%；肺结核痰或胃液涂片阳性占40.8%，培养占27.7%。值得高度重视的是本组误诊率高达78%（450/577）。治疗转归好转占85%，进展或恶化占3.7%，死亡占2.8%，其他61例占9.5%。结论：儿童结核病临床表现不典型，，化验结果阳性率不高，误诊率高，应加强临床儿科医生对结核病的认识，减少误诊率，达到尽早诊断及尽早及时有效治疗的目的，对控制儿童结核病的发病及提高预后效果起到实质性的作用。
[Abstract]:Objective: to strengthen the understanding of child tuberculosis in order to reduce the misdiagnosis and mistreatment of child tuberculosis and improve the prognosis of child tuberculosis treatment. Methods: the clinical data of 642 children with tuberculosis in our hospital from January, 2001 to December 31, 2011 were analyzed. Results: there were 58.4% males and 41.6 females in this group, 83.3% in rural areas (including floating population), 16.7% in cities, 68.1 cases in history of BCG inoculation, and 21.5% in contact history of definite tuberculosis patients. In 642 cases, pulmonary tuberculosis accounted for 36.9%, extrapulmonary tuberculosis 27.9%, systemic tuberculosis 33.8m, congenital tuberculosis 1.4%. Of the 306 cases with erythrocyte sedimentation rate, 67.9% were increased, "g () accounted for 26.8% of the results of blood analysis, WBC10*109/L accounted for 46.3% of the total number of patients with PLT 300 / 109 / L, and 65.8% of them accounted for 54.4g / L of HB 110g / L, 40.88g / L positive for sputum or gastric smear of pulmonary tuberculosis and 27.77g / L for culture. The misdiagnosis rate was as high as 78% (450 / 577). The recovery of treatment was 85%, progress or deterioration was 3.7%, death was 2.8%, and the other 61 cases were 9.5%. Conclusion: the clinical manifestation of child tuberculosis is not typical, the positive rate of test results is not high, and the misdiagnosis rate is high. The clinical pediatricians should strengthen the understanding of tuberculosis, reduce the misdiagnosis rate, and achieve the purpose of early diagnosis and prompt and effective treatment. To control the incidence of tuberculosis in children and improve the effect of prognosis play a substantial role.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1

【参考文献】