广西沿海沿边区域务工人员新发肺结核病临床及影像学特征研究

Study of the Clinical and Imaging Characteristics of New Pulmonary Tuberculosis in the Migrant Workers in Guangxi Coastal Area and Border Region

目的分析广西沿海沿边区域务工人员新发肺结核临床及影像学特征,为预防控制肺结核的流行与传播提供参考。方法选择2012年1月—2014年1月该院收治的80例患者为研究对象,其中40例务工新发肺结核为观察组,40例防城港常住人员新发肺结核为对照组,分析病历资料及治疗结果。结果观察组平均年龄(27.65±3.21)岁、文化程度(小学及以下2例,初中12例,高中25例,大学及以上1例)、失访率30.00%、治愈率为71.43%,对照组平均年龄为(54.36±6.12)岁,文化程度(小学及以下3例,初中15例,高中16例,大学及以上6例),失访率12.5%,治愈率为88.57%,两组数据比较差异有统计学意义(P<0.05);观察组患者Ⅲ型38例,痰菌阳性率为62.5%,复治病例8例,双侧肺受累25例,中下肺野病变30例,病变累及肺野数目2个及以上32例,对照组Ⅲ型32例,痰菌阳性率35.00%,复治病例2例,双侧肺受累17例,中下肺野病变22例,病变累及肺野数目2个及以上25例,两组数据比较差异有统计学意义(P<0.05)。结论外出务工人员新发肺结核表现为男性高于女性、多发于30岁以下、文化程度较低的流行病学特征,临床表现为Ⅲ型肺结核且复始病例多、治疗效果差等,影像学表现为病变分布广泛、病变累及数目多等特征。卫生行政部门应制定相应政策,以预防和控制务工人员肺结核病的流行。

Objective To analyze the clinical and imaging features of new pulmonary tuberculosis in the migrant workers in Guangxi coastal area and border region so as to provide a reference for controlling and preventing the prevalence and spread of pulmonary tuberculosis. Methods 80 cases admitted to this hospital from Jan 2012 to Jan 2014 were selected as the subjects 40 migrant workers with new pulmonary tuberculosis were selected as the observation group, and 40 permanent residents of Fangchenggang with new pulmonary tuberculosis were selected as the control group. And their medical records and treatment resuits were analyzed. Results In the observation group, the average age was （27.65＋3.21） years old, 2 cases had primary school education or below, 12 cases had junior middle school education, 25 cases had high school education, 1 case had university education or above, the loss rate was 30.00%, the cure rate was 71.43%; in the control group, the average age was （54.36±6.12） years old, 3 cases had primary school education or below, 15 cases had junior middle school education, 16 cases had high scbool education, 6 cases had university education or above, the loss rate was 12.5%, the cure rate was 88.57%, the differences between the groups were statistically significant （P〈0.05）. In the observation group, there were 95 cases with type Ⅲ, the positive rate of sputum bacteria was 62.5%, 8 rctreatment cases, 25 cases with bilateral lung involvement, 30 cases with middle and lower lung field lesions, 32 cases with lesions involving 2 or more lung fields; in the control group, there were 32 cases with type Ⅲ, the positive rate of sputum bacteria was 35.00%, 2 retreatment cases, 17 cases with bilateral lung involvement, 22 cases with middle and lower lung field lesions, 25 cases with lesions involving 2 or more lung fields, the differences in the data between the two groups were statistically significant（P〈0.05）. Conclusion The new pulmonary tuberculosis in the migrant workers presents the epidemiologie features that males and those people have low education under 30 years old have a higher incidence of the disease, the clinical manifestations are characterized by typeⅢ pulmonary tuberculosis, many retreatment cases, poor treatment effect and so on; the imaging manifestations show wide distribution of lesions, too many sites involved by the lesions and so forth. Administrative department of public health should formulate corresponding policies for controlling and preventing the spread of the disease.