新乡市2017—2021年骨与关节结核的临床表现分析

Clinical Analysis of Bone and Joint Tuberculosis in Xinxiang from 2017 to 2021

目的 总结新乡市2017—2021年骨与关节结核的临床表现特点,以期为骨与关节结核的防治策略提供科学依据。方法 收集2017—2021年新乡市6家医院的292例骨与关节结核住院患者作为研究对象。统计患者发病、年龄、性别、职业、居住地、病灶部位、合并其他部位结核、合并症等方面情况。结果 292例骨与关节结核患者中男178例(60.96%),女114例(39.04%)。255例(87.32%)患者因疼痛、功能障碍就诊,62例(21.23%)患者出现体温升高,其中39℃以上33例。发病时间为4 d~13 a。发病年龄1.5~92(51.15±20.46)岁,61岁以上患者最多,有113例(38.70%)。患者中农民最多,有212例(72.60%)。245例(83.91%)患者居住在8个县市,发病率为0.54/万;47例(16.09%)患者居住在4个市区,发病率为0.39/万。脊柱结核患者最多,有206例(70.55%),其次为髋、膝关节等关节结核,有63例(21.58%)。骨与关节结核合并肺结核有84例(28.77%),骨与关节结核合并其他部位结核有69例(23.63%)。骨与关节结核患者中,合并糖尿病24例。结论 近5 a新乡市骨与关节结核中脊柱结核发病率最高。半数以上骨与关节结核患者合并肺或其他部位结核。骨与关节结核起病隐匿,无特异性症状,少数患者出现高热,早期容易被误诊。

Objective To summarize the clinical characteristics of bone and joint tuberculosis in Xinxiang from 2017 to 2021, in order to provide scientific basis for the prevention and treatment of bone and joint tuberculosis.Methods A total of 292 patients with bone and joint tuberculosis from 6 hospitals in Xinxiang from 2017 to 2021 were collected as research subjects. The incidence, age, gender, occupation, habitation, lesion location, tuberculosis in other parts, complications were analyzed.Results Among 292 patients with bone and joint tuberculosis, 178 cases(60.96%) were male and 114 cases(39.04%) were female. There were 255 patients(87.32%) visited the hospital due to pain and dysfunction, 62 patients(21.23%) had elevated body temperature, of which 33 were above 39 ℃. The onset time was 4 days to 13 years. The age of onset ranged from 1.5 to 92(51.15±20.46) years old, the number of patients over 61 years old was the highest, with 113 cases(38.70%). Farmers were the most, with 212 cases( 72.60%). There were 245 patients(83.91%) lived in 8 cities and counties, with an incidence rate of 0.54 per 10 000, and 47 patients(16.09%) lived in 4 urban areas, with an incidence rate of 0.39 per 10 000. The patients with spinal tuberculosis were the most, with 206 cases(70.55%), followed by joint tuberculosis such as hip and knee joint, with 63 cases(21.58%). There were 84 cases(28.77%) of bone and joint tuberculosis complicated with pulmonary tuberculosis. There were 69 cases(23.63%) of bone and joint tuberculosis combined with tuberculosis in other parts. Among the patients with bone and joint tuberculosis, 24 cases were complicated with diabetes.Conclusion In recent five years, the incidence rate of spinal tuberculosis was the highest among bone and joint tuberculosis in Xinxiang, more than half of the patients with bone and joint tuberculosis have tuberculosis in the lung or other parts. Bone and joint tuberculosis has insidious onset and no specific symptoms, a few patients may have high fever, which is easy to be misdiagnosed in the early stage.