综合性医院肺结核病的分布、临床特征和管理现况分析

The current status analysis of distribution, clinical characteristics and management of pulmonary tuberculosis in a general hospital

目的 了解和分析综合性医院肺结核病的现况 ,发挥综合性医院在结核病防治中的作用。方法 对 1998年 1月～ 2 0 0 2年 3月间我院肺结核患者的资料进行调查和分析。结果 10 69例肺结核患者中 ,因症就诊者占 98.1% ,确诊时间为 3～ 3 6d。就诊科室分散 ,以呼吸科为主 ,构成比依次为呼吸科 64 .3 % ,内科 13 .7% ,外科 8.9% ,骨科 6.7%。X线检查受检率高 ,胸部X线检查阳性率为 81.4%。结核菌阳性率为 2 3 .7%。3 15例患者 (2 9.5 % )有糖尿病、结缔组织病等合并症。在诊治随访中 ,2 0 3例 (19.1% )诊断 1个月后中断随访 ,172例(16.1% )未转至结核病防治专业机构 ,12例死于严重并发症。结论 综合性医院对肺结核病例的发现、治疗和管理有待加强。

Objective To survey and analyze the distribution, clinical characteristics and managing status of pulmonary tuberculosis in a general hospital so as to find out the role in its prevention and treatment. Methods An analysis was conducted based upon the survey and registration materials from January,1998 to March,2002. Results Among 1 069 cases, with symptoms seeking for medical advice were 98.1% . The diagnosis was verified within 3～36 days with patients from the departments of respiratory medicine, internal medicine, surgery and orthopaedics, the rates were 64.3%, 13.7%, 8.9% and 6.7% respectively. Abnormal X ray findings ranked the highest, being 81.4%, positive bacteriological findings 23.7%. Among these, 315 cases(29.5%) had coexistent diabetes and connective tissue diseases etc. 203 cases(19.1%) were lost of follow up 1 month after diagnosis. 172 cases(16.1%) had not attended the specialized tuberculosis institution. 12 cases died of severe complications. Conclusion The discovery of pulmonary tuberculosis including disease control and prevention necessitates special medical care, its treatment and management should be enhanced.