咯血及血痰症状与可疑结核病患者临床诊断的相关性分析  

Analysis of correlation between hemoptysis or blood sputum symptoms and clinical diagnosis of cases with suspicious tuberculosis

作　　者：吴金瑶[1] 梁志强[1] 刘玉美[1] 宋涛[1] 刘志辉[1] 

机构地区：[1]广州市胸科医院,510095

出　　处：《国际医药卫生导报》2017年第12期1835-1837,共3页International Medicine and Health Guidance News

基　　金：基金项目：厂东省科技计划项目（20138021800060）;广州市科技计划项目（2014Y2-00117）;厂州市科技计划项目（155700012）

摘　　要：目的分析咯血、血痰症状在常见呼吸系统疾病中的发生情况，为临床诊疗提供科学循证依据。方法回顾性分析本院结核病防治所4938例肺结核可疑症状者资料，将其分为咯血、血痰患者组（简称“A组”）和非咯血、血痰患者组（简称“B组”），分析并比较两组肺结核（包括菌阳肺结核和菌阴肺结核）、非结核肺部疾病（包括肺癌、肺炎和其它肺部疾病）和肺部健康（包括陈旧性肺结核和正常）诊断结果情况。结果在346例A组和4592例B组患者中，临床最终诊断为肺结核、非结核肺部疾病、肺部健康的患者数分别为210、68、68例和2736、756和1100例，分别占各组病例数的60．69％、19．65％、19．65％和59．58％、16．46％和23．95％。经x^2检验两组比较，A组患者的菌阳肺结核、肺结核总数、肺癌、其它肺部疾病的发生率显著高于B组（P〈0．05），陈旧性肺结核则反之，菌阴肺结核、肺炎、非结核肺部疾病总数、正常和肺部健康总数的水平两组比较差异无统计学意义（P〉0．05）。结论有咯血、血痰症状者极有可能患肺结核尤其是菌阳肺结核，并注意与肺癌的鉴别诊断。Objective To provide a scientific evidence-based basis for diagnosis and treatment by analysis of occurrence frequency of hemoptysis, bloody sputum symptoms in the common respiratory diseases. Methods Four thousand nine hundred thirty-eight cases with suspicious tuberculosis were divided into hemoptysis or blood sputum group （346 cases, group A） and non-hemoptysis or non-blood sputum group （4 592 cases, group B）. Frequencies and percentages of pulmonary tuberculosis （including bacteriological positive and bacteriological negative）, non-tuberculosis lung diseases （including lung cancer, pneumonia, and other lung diseases）, and healthy people （including inactive tuberculosis and normal lung） were analyzed and compared retrospectively. Results There were 210 cases （60.69%） with pulmonary tuberculosis, 68 cases （19.65%） with non-tuberculosis lung diseases, and 68 healthy individuals （19.65%） in group A, while those in group B were 2 736 cases （59.58%）, 756 cases （16.46%）, and 1 100 cases （23.95%）. x^2 test showed that the incidences of pulmonary tuberculosis, bacteriological positive tuberculosis, lung cancer, and other lung diseases in group A were significantly higher than those in group B （P〈0.05）. And it was the opposite for inactive tuberculosis. There were no statistically significant differences in bacteriological negative tuberculosis, pneumonia, non-tuberculosis lung diseases, normal lung and healthy people between group A and group B （P〉0.05）. Conclusions The cases with hemoptysis or blood sputum symptoms are likely to suffer from tuberculosis, especially bacteriological positive tuberculosis. And we must pay attention to differentiating from lung cancer.

关 键 词：结核/肺 可疑症状 咯血 临床诊断 

分 类 号：R52[医药卫生—内科学]