【摘要】：目的：為加強(qiáng)對(duì)兒童結(jié)核病的認(rèn)識(shí)，以盡量降低對(duì)兒童結(jié)核病的誤診、誤治，改善兒童結(jié)核病治療預(yù)后。 方法：對(duì)2008.1.1-2011.12.31期間在我院住院的642例兒童結(jié)核病資料進(jìn)行臨床總結(jié)分析。 結(jié)果：本組病例中男58.4%，女41.6%；農(nóng)村（包括流動(dòng)人口）83.3%，城市占16.7%；有卡介苗接種史68.1%，有明確結(jié)核病人接觸史占21.5%，；642例中肺內(nèi)結(jié)核占36.9%，肺外結(jié)核占27.9%，全身性結(jié)核病占33.8%，先天性結(jié)核病占1.4%；臨床表現(xiàn)中，盡管千差萬別，但兒童結(jié)合補(bǔ)丁中，具有不規(guī)則發(fā)熱達(dá)55.5%，；血沉306例中增快占67.9%，PPD試驗(yàn)299例中，"g（++）占26.8%；605例做了血液分析結(jié)果中WBC10*109/L占46.3%，PLT300*109/L占65.8%，Hb110g/L占54.4%；肺結(jié)核痰或胃液涂片陽性占40.8%，培養(yǎng)占27.7%。值得高度重視的是本組誤診率高達(dá)78%（450/577）。治療轉(zhuǎn)歸好轉(zhuǎn)占85%，進(jìn)展或惡化占3.7%，死亡占2.8%，其他61例占9.5%。 結(jié)論：兒童結(jié)核病臨床表現(xiàn)不典型，，化驗(yàn)結(jié)果陽性率不高，誤診率高，應(yīng)加強(qiáng)臨床兒科醫(yī)生對(duì)結(jié)核病的認(rèn)識(shí)，減少誤診率，達(dá)到盡早診斷及盡早及時(shí)有效治療的目的，對(duì)控制兒童結(jié)核病的發(fā)病及提高預(yù)后效果起到實(shí)質(zhì)性的作用。
[Abstract]:Objective: to strengthen the understanding of child tuberculosis in order to reduce the misdiagnosis and mistreatment of child tuberculosis and improve the prognosis of child tuberculosis treatment. Methods: the clinical data of 642 children with tuberculosis in our hospital from January, 2001 to December 31, 2011 were analyzed. Results: there were 58.4% males and 41.6 females in this group, 83.3% in rural areas (including floating population), 16.7% in cities, 68.1 cases in history of BCG inoculation, and 21.5% in contact history of definite tuberculosis patients. In 642 cases, pulmonary tuberculosis accounted for 36.9%, extrapulmonary tuberculosis 27.9%, systemic tuberculosis 33.8m, congenital tuberculosis 1.4%. Of the 306 cases with erythrocyte sedimentation rate, 67.9% were increased, "g () accounted for 26.8% of the results of blood analysis, WBC10*109/L accounted for 46.3% of the total number of patients with PLT 300 / 109 / L, and 65.8% of them accounted for 54.4g / L of HB 110g / L, 40.88g / L positive for sputum or gastric smear of pulmonary tuberculosis and 27.77g / L for culture. The misdiagnosis rate was as high as 78% (450 / 577). The recovery of treatment was 85%, progress or deterioration was 3.7%, death was 2.8%, and the other 61 cases were 9.5%. Conclusion: the clinical manifestation of child tuberculosis is not typical, the positive rate of test results is not high, and the misdiagnosis rate is high. The clinical pediatricians should strengthen the understanding of tuberculosis, reduce the misdiagnosis rate, and achieve the purpose of early diagnosis and prompt and effective treatment. To control the incidence of tuberculosis in children and improve the effect of prognosis play a substantial role.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.1

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