摘要
目的总结婴幼儿肺结核的临床特点。方法对37例婴幼儿肺结核的结核接触史、临床表现、卡介苗接种情况、PPD试验结果、实验室检查、影像学特点进行回顾性分析。结果 37例患儿有结核接触史者22例(59.4%),高原常住儿童37例(100%),卡介苗接种者3例(8.1%);发热34例(91.9%),有呼吸道症状者31例(83.8%),有神经系统症状者7例(18.9%),CRP升高者23例(62.1%),血常规检查白细胞升高28例(75.7%),胸部CT检查异常者37例(100%),头部CT异常者5例(13.5%),头部MRI异常者6例(16.2%),PPD(+)者25例(67.5%)。最后诊断为原发性肺结核4例(10.8%),血行播散型肺结核11例(29.7%),继发性肺结核22例(59.5%),并发结核性胸膜炎者5例(13.5%),并发结核性脑膜炎者9例(24.3%)。结论婴幼儿结核有一定的临床特点,临床医生应高度重视,作出早期诊断;同时应加强高原常住儿童的结核病防治工作,提高高原常住儿童的卡介苗接种率。
Objective To analyze the clinical features of pulmonary tuberculosis in infant. Methods The clinical features of 37 cases with pulmonary tuberculosis in infant were analyzed, including contact history with tuberculosis, clinical manifestation, including BCGvaecine, PPD test, laboratory examination and imaging. Results 22 cases （59. 4%） had contact history with tuberculosis, 37 cases（100%） were infant frequently reside in altiplano, 3 cases（8. 1%）were found with BCG vaccine, 34 cases（91.9%） were found with fever, 31 cases（83.8%） with respiratory symptom, 7 cases （18.8%） with nerve system symptom, 23 cases（62. 1%） with elevatory CRP, 28 cases（75.7%） with leucocytosis. Chest CT examination was performed in 37 cases and 37cases （100%） were abnormal, five cases （13. 5 %） showed the signs of abnormal by CT on Head, six cases（16.2%） showed the signs of abnormal by MRI on Head. 25 cases（67.5%） were found with positive PPD test. Finally, 4 cases（10.8%） were diagnosed with primary pulmonary tuberculosis, 11 cases（29.7 %） with hematogenous pulmonary tuberculosis, 22 cases （59.5 %） with secondary pulmonary tuberculosisis, 5 cases（13.5%） with tuberculosis pleurisy and 9 cases（24.3%） with tuberculosis meningitis. Conclusion Pulmonary tuberculosis in infant has a certain clinical characteristics and clinical physician should attachweight to the early diagnosis. Prevention and cure with pulmonary tuberculosis in infant frequently reside in altiplano should be strengthened and BCG vaccination in infant frequently reside in altiplano should be extended.
出处
《西部医学》
2012年第6期1132-1133,1136,共3页
Medical Journal of West China
关键词
肺结核
婴幼儿
临床分析
Pulmonary tuberculosis
Infant
Clinical analysis
