成都市公共卫生临床医疗中心收治的骨与关节结核患者流行病学及结果初步分析  

Epidemiology and Preliminary Analysis of Tuberculosis Patients with Bone and Joint Tuberculosis Admitted to Chengdu Public Health Clinical Medical Center

作　　者：李邦银 蒋曦 蒲育 何敏 刘勇 曾义岚 Li Bangyin;Jiang Xi;Pu Yu(Department of Orthopedics and Medical Record Room,Chengdu Public Health Clinical Medical Center,Chengdu,Sichuan 610061,China)

机构地区：[1]成都市公共卫生临床医疗中心骨科,病案室,四川成都610061

出　　处：《四川医学》2020年第6期566-569,共4页Sichuan Medical Journal

基　　金：四川省科技厅项目(编号:2017TJPT0013);成都市科技局项目(编号:2015-HM02-00092-SF)。

摘　　要：目的了解骨与关节结核患者的流行病学特点,以采取一定措施,降低发病率,提高疗效。方法回顾性分析成都市公共卫生临床医疗中心2006年1月至2016年12月收治的2173例骨与关节结核临床资料,患者按性别、年龄、职业、患者来源、患病部位的分布、合并症、耐药情况进行统计分析。结果骨与关节结核发病率男性高于女性,差异有统计学意义(χ^2=138.20,P<0.01);青、中年发病率高于其他年龄段,差异有统计学意义(χ^2=786.51,P<0.01);重体力劳动者高于一般劳动者,差异有统计学意义(χ^2=407.54,P<0.05);青、中年骨关节结核患者合并肺结核或结核性胸膜炎最常见,0-24岁年龄段患者中,合并肺结核或结核性胸膜炎比例高于合并高血压、糖尿病或艾滋病,差异有统计学意义(χ^2=127.21,P<0.05)。少数民族高于汉族,欠发达地区高于发达地区;脊柱结核多于关节结核,脊柱结核以胸、腰椎多发,关节结核以髋、膝关节多发。结核耐药率高达17.53%,总体有效率为95.67%。结论骨与关节结核疫情严重,宜加大防治力度。以少数民族地区、偏远地区、农村为防控重点,以青中年、重体力劳动者为重点关注对象,切实降低骨与关节结核发病率,发病后规范综合治疗,结核病治疗效果良好。Objective To understand the epidemiological characteristics of patients with bone and joint tuberculosis that would help to take certain measures to reduce the incidence and improve the efficacy.Methods From January 2006 to December 2016,clinical data of 2173 cases of tuberculosis of bone and joints in Chengdu public health clinical medical center were retrospectively analyzed.All patients were statistically analyzed according to gender,age,occupation,source of the patient,distribution of diseased parts,complications,and drug resistance.Results The incidence of tuberculosis of bone and joint was higher in males than in females,the difference was statistically significant(χ^2=138.20,P<0.01).The incidence of young and middle-aged was higher than other age groups,the difference was statistically significant(χ^2=786.51,P<0.01).Heavy physical workers were higher than ordinary workers with statistically significant difference(χ^2=407.54,P<0.05).Young and middle-aged patients with bone and joint tuberculosis combined with pulmonary tuberculosis or tuberculous pleurisy were the most common.Among patients aged 0-24 years,the proportion of patients with tuberculosis or tuberculous pleurisy was higher than that with hypertension,diabetes or AIDS(χ^2=127.21,P<0.05).The ethnic minorities were higher than the Hans,and the less developed areas were higher than the developed areas.Spinal tuberculosis was more than joint tuberculosis,spinal tuberculosis was more frequent in the chest and lumbar spine,and joint tuberculosis was more frequent in the hip and knee joints.The tuberculosis drug resistance rate was as high as 17.53%,and the overall effective rate was 95.67%.Conclusion The outbreak of tuberculosis in bones and joints is serious so that prevention and treatment should be strengthened.The focus should be on minority,remote and rural areas,and on young and middle-aged and heavy manual workers.We would effectively reduce the incidence of bone and joint tuberculosisand standardize comprehensive treatment after onset.

关 键 词：结核 骨与关节 流行病学 

分 类 号：R529.2[医药卫生—内科学]