维持性血液透析患者并发结核感染的诊治

To retrospective analysis of tuberculosis in patients undergoing maintenance hemodialysis

目的:分析维持性血液透析患者并发结核早期诊治特点,以减少误诊及治疗中的不良反应。方法:回顾性分析我院6例维持性血透患者并发结核感染的临床特点以及抗痨治疗效果和治疗中出现的不良反应。结果:152例维持性血透患者中合并结核感染6例,其中肺外结核4例,主要症状有消瘦、乏力、纳差、发热。多数病例抗结核治疗有效,2例患者出现周围神经病变,球后视神经炎,停药后症状好转。结论:维持性血液透析患者并发结核感染时肺外结核发生率高,临床表现不典型,易误诊。早期诊断,合理抗痨治疗可改善患者的预后。

Objective： To improve early diagnosis and outcome of tuberculosis （ TB ） in patients under-going maintenance hemodialysis （ HD）, and then reduce the bad reactions. Methods： Six cases among our patients undergoing HD from 1995 to 2005 were indentified, and the clinical presentions, diagnostic procedures, management, and certain bad reactions were analyzed. Results： The incidence of TB in HD patients was 3.95%. The extrapulmonary TB was accounting for 66.7%. The symptoms included emaciation,lack of power, no appetite, fever. Most of patients were sensitive to anti-TB agents. Conclusion ： The TB should be diagnosed carefully and treated promptly if suspected in patients during the period of HD.