涂阴病人的诊治与管理

Diagnosis and Treatment Management of Patients with Smear-negative Tuberculosis

目的探讨涂阴肺结核病人相关的诊断治疗方法,以减少新的传染源及耐药的产生。方法对新疆维吾尔自治区2002～2007年涂阴病人(初、复治病人),通过痰涂片检查、X线动态观察、临床症状等进行分析。结果菌阴病人临床症状多以咳嗽咳痰、乏力盗汗为主,但症状相对较轻,约20%的病人为无症状,在体检时发现。结论咳嗽咳痰≥3周时进行痰检,对涂阴病人培养,可获得较高的阳性结果;咳嗽咳痰≥3周阳性检出率23%,涂阴培阳率13%。

Objective To investigate the diagnosis and treatment of patients with smear - negative tuberculosis to reduce new sources of infection and drug resistance. Methods Patients with smear - negative in Xinjiang from 2002 to 2007 （ patients with initial treatment and second treatment） were analyzed by sputum smears, dynamic X- ray observation, clinical symptoms, etc. Results The clinical symptoms mainly were cough and expectoration, fatigue, night sweats, but the manifestation was relatively slight, and 20% of the patients were found by physical examination without any symptoms. Conclusions The high positive result can be obtained in sputum culture and sputum examination when cough and expectoration are for and over 3 weeks, with the detection rate of 23% and positive culture rate of 13% in patients with smear- negative tuberculosis.