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目的分析血行播散性肺结核临床特点及影响疗效的相关因素。方法回顾性分析某院收治的146例血行播散性肺结核患者的临床资料,统计分析患者临床表现以及其疗效的相关因素。结果 (1)居住地以农村人口居多;就诊季节全年分散;发病年龄以<12岁及>40岁多见;有明确肺结核患者接触史37例;职业以农民为主;(2)症状以发热、咳嗽多见;体征以呼吸道体征、淋巴结肿大多见;(3)多因素分析显示:居住地为农村、合并基础疾病及肺外疾病、临床症状≥3种、痰抗结核抗体阳性、未规律服药及督导是影响疾病治疗效果的独立危险因素(P<0.05)。结论血行播散性肺结核农村居民发病率高,以小儿、中老年群体多见,多合并基础疾病,强化动态X线监测,辅以重复细菌学检查是降低漏诊的关键,为提高治疗效果,需积极控制上述独立危险因素。
Objective To analyze the clinical characteristics of hematogenous disseminated pulmonary tuberculosis and its related factors. Methods The clinical data of 146 patients with disseminated pulmonary tuberculosis hematogenous disseminated in a hospital were retrospectively analyzed. The clinical manifestations and related factors of their efficacy were statistically analyzed. Results (1) Most rural residents live in the place of residence; The year of treatment is scattered throughout the year; The age of onset is more common in <12 years and> 40 years; There are 37 cases of history of exposure to tuberculosis; Occupation is dominated by peasants; (3) Multivariate analysis showed that the place of residence was rural, with underlying and extrapulmonary diseases, the clinical symptoms were more than 3, the sputum and anti-tuberculosis antibodies were positive, and the signs of respiratory symptoms and lymph nodes were common. Regular medication and supervision were independent risk factors influencing disease treatment (P <0.05). Conclusion The incidence of rural residents with hematogenous disseminated pulmonary tuberculosis is high. It is more common in children and middle-aged and elderly people. More complicated basic diseases, enhanced dynamic X-ray monitoring and repeated bacteriological examination are the key points to reduce the missed diagnosis. To improve the therapeutic effect, Active control of these independent risk factors.