痰涂片阳性与阴性初治肺结核患者临床状况的比较

Clinical Comparison in First-Visit Patients with Smear-Positive and Smear-Negative Pulmonary Tuberculosis

目的通过对痰涂片阳性(简称涂阳)与痰涂片阴性(简称涂阴)初治肺结核患者患病前后的情况进行比较分析,了解涂阳肺结核患者的高危因素、疾病特征和心理特点。方法对101例初治肺结核患者(涂阴55例、涂阳46例)患病前后的有关情况进行问卷调查,并采用描述性统计、χ2检验及秩和检验进行统计学分析。结果涂阳组与涂阴组患者在性别、患病前的健康状况、劳累程度、确诊时间、治疗时间、血浆白蛋白、抑郁发生率和血糖等方面均有统计学意义(P<0.01或P<0.05)。结论保持良好的健康状况、避免过度劳累、积极治疗和控制各种慢性病对预防肺结核的发生、减轻病情、降低传染性具有重要意义;肺结核的高危人群应定期体检;对肺结核患者应做好饮食指导及心理辅导,帮助患者树立战胜疾病的信心和良好的心态,以利于疾病的康复。

Objective To investigate risk factors, clinical manifestation and psychological features of smear-positive patients by comparing smear-positive and smear-negative tuberculosis （TB） patients before and after treatment. Methods One hundred and one patients （smear-negative 55 cases, smear-positive 46 cases） with pulmonary TB in first-visit were investigated by self-designed questionnaire. Descriptive statistics, chi-square test, and rank sum test were used for statistic analysis. Results There were significant difference between smear-positive group and smear-negative group in gender, health status,degree of tiredness, diagnosing time, treatment duration, serum albumin, prevalence of suppression and prevalence of hyperglycemia（ P 〈0.01 or P 〈0.05）. Conclusion Keeping good health status, avoiding over-fatigue, preventing and controlling all kinds of chronic diseases could have great significance to prevent the occurrence of pulmonary TB, relieving discomfort and reducing infectivity. Those susceptible population to TB should receive physical examination periodically. To those diagnosed patients, especially smear-positive, nursing interventions, including dietary education and psychological nursing, could improve their confidence and mental status.