本文選題：四川省中醫(yī)院　切入點：患者　出處：《成都中醫(yī)藥大學》2013年碩士論文

【摘要】：目的：為了遏制艾滋病的增長態(tài)勢,保護人民健康,減少醫(yī)務人員的職業(yè)暴露風險,開展四川省中醫(yī)院患者HIV感染的臨床研究。 方法：對四川省中醫(yī)院2012年度檢驗科免疫室HIV抗體初篩試驗陽性,且經成都市疾病預防控制中心進行確證試驗的患者,依照現行納入和排除標準進行篩選。并對HIV/AIDS住院病例進行回顧性分析。 結果：2012年度四川省中醫(yī)院HIV抗體初篩試驗陽性患者60例,排除陰性、可疑陽性及資料不全者10例,納入50例,男性43例,女性7例。包括門診患者8例,住院患者42例。年齡最小18歲,最大86歲,中位年齡38.5歲。2012年度醫(yī)院收治住院患者共計31809例,檢出HIV/AIDS患者42例,檢出比為0.13%。列入研究的科室23個,檢出HIV/AIDS患者1例以上的科室17個,占65.4%。這17個科室收治住院患者共計25060例,檢出HIV/AIDS患者42例,檢出比為0.17%。檢出病例數前五位的科室為肛腸科(7例)、皮膚科(5例)、泌尿外科(4例)、急診科(4例)、呼吸科(3例)。檢出百分比前五位的科室則為皮膚科0.44%、泌尿外科0.35%、針灸科0.33%、肛腸科0.21%、急診科0.20%。主要以皮膚斑丘疹,肛門腫物脫出,肛旁腫痛,咳嗽、咳痰、呼吸困難、腹瀉、消瘦等癥狀就診。入院診斷中以社區(qū)獲得性肺炎,痔瘡,帶狀皰疹,肛周膿腫常見。中醫(yī)舌脈中,以色紅,黃膩苔,滑數脈常見,實證居多。中醫(yī)臨床分期與西醫(yī)臨床分期比較,兩者存在相關性(rk=0.773,P=0.000)。艾滋病期患者13例,以反復的細菌性肺炎、帶狀皰疹、反復腹瀉、發(fā)熱為入院診斷。HIV/AIDS患者中,45.2%合并有其他性傳播疾病,梅毒常見。檢出7種WB帶型,p55、p17出現頻率較低。肺部影像以廣泛磨玻璃樣改變及肺炎表現常見。 結論：HIV/AIDS已經成為四川省中醫(yī)院的常見病種之一。職業(yè)暴露的潛在危險日漸顯露,但是醫(yī)務人員對嚴峻的AIDS增長態(tài)勢尚未引起足夠的重視。加強AIDS防控知識教育已經迫在眉睫,而開展中醫(yī)、中西醫(yī)結合臨床研究的歷史機遇也已經來臨。
[Abstract]:Objective: in order to control the increasing trend of AIDS, protect the health of the people and reduce the occupational exposure risk of medical personnel, the clinical study of HIV infection among patients in Sichuan traditional Chinese medicine hospital was carried out.Methods: the patients who were tested positive for HIV antibody in the immunological laboratory of Sichuan traditional Chinese Medicine Hospital in 2012 were screened according to the current criteria of inclusion and exclusion, which were confirmed by Chengdu Centers for Disease Control and Prevention.The inpatients with HIV/AIDS were analyzed retrospectively.Results among 60 patients with positive HIV antibody test in Sichuan traditional Chinese Medicine Hospital in 2012, 10 cases were excluded negative, suspicious positive and incomplete data, 50 cases were included, 43 cases were males and 7 cases were females.There were 8 outpatients and 42 inpatients.The median age was 38.5 years old. The median age was 38.5 years. A total of 31809 inpatients were admitted in the hospital in 2012. 42 cases of HIV/AIDS were detected, and the detection ratio was 0.13%.Of the 23 departments included in the study, 17 (65.4%) had more than one case of HIV/AIDS.A total of 25060 inpatients were admitted to these 17 departments, 42 cases of HIV/AIDS were detected, the detection ratio was 0.17%.In the first five departments, there were 7 cases of anal and intestinal diseases, 5 cases of dermatology, 4 cases of urology, 4 cases of emergency diagnosis and 3 cases of respiratory diseases.The first five departments were dermatology 0.44, urology 0.35, acupuncture 0.33, anorectal 0.21, emergency 0.20.Mainly with skin spot papules, anal tumor prolapse, perianal swelling, cough, expectoration, dyspnea, diarrhea, wasting and other symptoms.Community acquired pneumonia, hemorrhoids, herpes zoster and perianal abscess are common in admission diagnosis.In tongue vein of traditional Chinese medicine, color red, yellow greasy fur, smooth number of veins are common, empirical evidence is the majority.There was a correlation between the clinical stage of TCM and the clinical stage of western medicine.13 cases of AIDS were diagnosed by repeated bacterial pneumonia, herpes zoster, repeated diarrhea and fever. 45.2% of HIV / AIDS patients were diagnosed with other sexually transmitted diseases, syphilis was common.It was found that the frequency of p55 p17 was lower than that of 7 types of WB band type.Pulmonary imaging is common with extensive glass-like changes and pneumonia.Conclusion HIV / AIDS has become one of the most common diseases in Sichuan Provincial Hospital of traditional Chinese Medicine.The potential risks of occupational exposure are emerging, but medical staff have not paid enough attention to the grim growth of AIDS.It is urgent to strengthen the knowledge education of AIDS prevention and control, and the historical opportunity of developing TCM and integrating traditional Chinese medicine and western medicine has come.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R512.91

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