传染性肺结核患者胸片对比分析

Comparison and analysis of chest radiography on infectious pulmonary tuberculosis

[目的 ] 对痰菌涂片阳性肺结核患者的胸片进行对比分析 ,探讨胸片检查与痰涂片检查在肺结核防治工作中的意义。 [方法 ] 收集 2 0 0 3年 7月～ 2 0 0 4年 6月肺结核新登记菌阳病例 3 5 4例 ,其中初治痰阳 2 3 5例 ,复治痰阳119例 (复治病例含复发者 3 7例 ,初治失败者 19例 ,其它复治者 63例 ) ,对本次确诊时第 1张胸片结果进行对比分析。 [结果 ] 初治痰阳患者的胸片表现以渗出浸润型为主 ,占 5 1.91% (12 2 / 2 3 5 ) ,纤维硬化型占 0 .85 % (2 / 2 3 5 ) ;复治痰阳患者胸片表现纤维硬化型为主 ,占 3 8.66% (4 6/ 119) ,渗出浸润型占 2 6.0 5 % (3 1/ 119) ,复治病例包括复发者、初治失败者及其它复治者 ,这 3种情况确诊时的第 1张胸片结果又有显著性差异。 [结论 ] 肺结核患者的胸片表现各不相同 ,不能单凭胸片结果来判断其传染性 ,尤其对于复治病例痰检结果对判断病情活动更有重要意义。

Objective To explore the significance of chest radiography and phlegm examination in the control of pulmonary tuberculosis. [Methods] A total of 354 samples of pulmonary tuberculosis patients with phlegm positive were collected from July 2003 to June 2004. 235 cases were phlegm positive at the first treatment and 119 cases were phlegm positive at repeated treatment including 37 cases of recurrence, 19 cases of failure in the first treatment, 63 cases with other repeated treatment .The chest radiography were compared and analyzed in the first examination. [Results] The chest radiography of patients who were treated for the first time: exudative type were 51.91%(122/235) and fibrotic sclerosis type were 0.85%(2/235).The chest radiography of phlegm positive patients who had repeated treatment : fibrotic sclerosis type were 38.66%(46/119) and exudative types were 26.05%(31/119).The result were different between recurrence and failure in the first treatment and the other repeated treatment. [Conclusion] The chest radiography of pulmonary tuberculosis patients is different. We should not judge their infectivity only with chest radiography. Phlegm examination is essential to pulmonary tuberculosis, especially for patients with repeated treatments.