儿童肺结核病73例临床分析

Clinical analysis of 73 childish patients with pulmonary tuberculosis

目的提高对儿童肺结核的认识。方法回顾性分析1998～2010年收治的73例儿童肺结核病例。结果儿童肺结核临床症状无特异性,误诊为上呼吸道感染、肺炎37例,误诊率50.7%,延误时间平均15 d。采用短程化疗方案(2HRZS/4HR)治疗,治愈率为90.9%。结论胸部X线表现,痰细菌学检查,结核菌素试验对儿童肺结核的诊断有重要意义。重视儿童肺结核的特点,综合分析各种临床资料才能提高诊断率。儿童肺结核短程化疗方案效果良好。

Objective To raise the cognition of pulmonary tuberculosis in children.Methods The clinical data of 73 childish patients with tuberculosis admitted in this department during 1998~2010 were retrospectively analyzed.Results Children infected with tubrculosis usually have no specific clinical symptoms,they were always misdiagnosed as upper respiratory tract infection or pneumonia in 37 cases of this series,the misdiagnosis rate reached 50.7%,and the average duration for delayed diagnosis was 15 d.The cure rate of 2HRZS/4HR therapy was 90.9%.Conclusion The information about history of illness,chest X-ray examination,bacteriological examination of sputum and PPD intradermal test are important for diagnosing tuberculosis in children.Pay more attention to the characteristics of childish tuberculosis and comprehensive analysis of various clinical data can raise the rate for accurate diagnosis.The efficacy of short-term course of chemotherapy in treatment of childish tuberculosis is good.