血行播散型肺结核临床分析

目的分析血行播散型肺结核临床特点。方法对2003～2006年收治的34例血行播散型肺结核临床特点作回顾性分析。结果（1）血行播散型肺结核以青壮年居多，老年患者渐有增多的趋势。（2）85．3％在出现临床症状后〉1月确诊。（3）全身症状明显（发热67．6％），呼吸道症状以咳嗽、咳痰居多。（4）痰涂片找核酸杆菌阳性率23．5％，50％PPD试验阴性，35．3％末梢血白细胞不正常，5．8％肝功障碍。（5）52．9％并发肺外结核，20．6％合并非结核性疾病。（6）早期、联合、规律、全程、适量抗结核治疗，对并发症及合并病治疗，97．1％的病例临床治愈。结论血行散播型肺结核是重症肺结核之一，症状重，并发症、合并症多。经有效抗结核治疗，对症治疗不同并发症及合并症，获得了满意的疗效。

Clinical analysis of hematogenous disseminated pulmonary tuberculosis

Objective To analyze the clinical characteristics of hematogenous disseminated pulmonary tuberculosis （HDPT）. Methods A retrospective analysis of 34 inpatients （ from 2003 to 2006） of HDPT was conducted. Results （ 1 ） HDPT was more prevalent in adult than in younger population. It was becoming increasingly prevalent among elder population though, （2） 85, 3% of the total study sample had the diagnosis confirmed after 1 months of their symptom appearance. （3） The disease had shown systemic symptoms, predominantly with fever （67.6%）. The primary symptoms shown in respiratory system were cough and expectoration. （4） The sputum smear positive rate （and fast bacilli） was 23.5%. 50.0% of the patients bad PPD skin test negative. Lab results： 35, 3% of patients showed a decrease of the WBC count. Among the total, 5, 8% had hepatic function disturbance. （5） 52.9% of patients had complication of extra pulmonary tuberculosis and 20. 6% with non-tuberculosis disease. （6） 97. 1% of the total study sample had shown positive outcomes after treatment, indicating overall satisfactory results achieved. Conclusion HDPT was one of the severe tuberculosis of extra-ornon-tuberculosis diseases, However, with anti-tuberculosis therapy strengthened and proper concomitant therapy for its complications, the treatment effects can be satisfactory.