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目的:调查分析湖南省综合性医院住院病例中儿童结核病的情况。方法:回顾性调查2006年1月至2008年3月间湖南省13所综合性医院住院病人中诊断为结核病的0-14岁儿童结核病例。结果:共调查到儿童结核病(不含潜伏结核感染病例)195例,男﹕女为1.67:1,农村居住与城市居住结核病人数比为2.67:1;发病比率最高的前三位依次为肺结核、结核性脑膜炎(含结核性脑膜脑炎)、淋巴结核;患病年龄以学龄期儿童(6-14岁)最多,婴儿期最少;不同年龄段结核类型有所不同,学龄期儿童以肺结核为主,其他各年龄组则多为肺外结核(淋巴结核、结核性脑膜炎);有结核病接触史者78例,有卡介苗接种史123例,其中,明确记录卡痕者62例;无卡介苗接种史或不详的患儿中结脑比率(36.1%)显著高于有卡介苗接种史患儿(28.5%);住院病例结核诊断手段多种多样,使用最多的为PPD皮试及淋巴活检。结论:我省综合医院住院儿童结核病患者并不少见,但危重结核类型比重大,其中以学龄期儿童患病人数多,卡介苗接种质量有待提高,我省儿童结核防治之路仍然任重而道远。
Objective: To investigate and analyze the prevalence of childhood tuberculosis among inpatients in Hunan General Hospital. Methods: A retrospective survey of tuberculosis cases in children aged 0-14 years diagnosed as tuberculosis among inpatients in 13 general hospitals in Hunan Province from January 2006 to March 2008 was conducted. Results: A total of 195 children with tuberculosis (excluding latent tuberculosis) were enrolled in this study. The male to female ratio was 1.67: 1. The ratio of rural living to urban living TB was 2.67: 1. The top three highest incidence rates were tuberculosis, Tuberculous meningitis (including tuberculous meningoencephalitis), lymph node tuberculosis; prevalence of age to school-age children (6-14 years old) the most, the youngest period; different age tuberculosis types are different, school-age children with tuberculosis as The main, other age groups are mostly extrapulmonary tuberculosis (tuberculosis, tuberculous meningitis); a history of exposure to TB in 78 cases, history of BCG vaccination in 123 cases, of which 62 were clearly documented signs of card; BCG vaccination The prevalence of tuberculous meningitis (36.1%) in children with or without history was significantly higher than that in children with a history of BCG vaccination (28.5%). There were a variety of diagnostic tools for tuberculosis in hospitalized patients, most commonly using PPD skin tests and lymph biopsies. Conclusions: It is not uncommon for tuberculosis patients to be hospitalized in General Hospital of our province, but the proportion of critical tuberculosis is very large. Among them, the prevalence of school-age children is high and the quality of BCG vaccination needs to be improved. The prevention and treatment of tuberculosis in children in our province still has a long way to go .