儿科综合性医院结核病发病情况分析

Investigation of tuberculosis disease in a pediatric hospital

目的通过调查分析儿童结核病在非结核病专科的儿科医院的发病情况,进一步探讨儿童结核病的发病特点。方法收集近九年收住的出院诊断为结核病的患者病史,并进行重新评估,对符合诊断的103例患儿的临床资料作回顾性分析。结果结核病诊断率增加,以7～14岁年龄段发病率较高(占35.92%);19.2%有明显的结核病接触史,主要集中在4岁以下的儿童,传染源多为日常密切接触的家人;28%患儿结核菌素试验阴性,其结核类型主要为粟粒型肺结核、结核性脑膜炎等,中、重症结核病表现多见;结核病患儿中出现发热、咳嗽等症状者仅50%左右。结论我国儿童结核病流行趋势严峻,各年龄段发病率不同,结核病患儿的临床表现多样化,临床诊断手段匮乏,需要进一步加强研究。

Objectives To retrospectively investigate the epidemiology and incidence of tuberculosis in a pediatric hospital, and to further study the characteristics of tuberculosis in children. Methods Clinical data of 103 children with tuberculosis were reviewed. Results The incidence was highest in patients aged between 7 and 14 years （35.92%）. 19.2% had contact with patients with active tuberculosis, most of them were the children younger than 4 years. The sources of the infection were the parents and relatives. PPD test was negative in 28% of the severely infected patients, such as miliary tuberculosis, tuberculous meningitis. Only half of the patients developed fever and cough. Conclusions The prevalence of tuberculosis in children is still high in China, and their clinical manifestations could be atypical. Diagnosis of tuberculosis requires methods with higher specificity and sensitivity.