重症肺结核定义的概况性评价  

Definition of severe pulmonary tuberculosis:a scoping review

作　　者：吴守媛 兰慧 刘云兰 孙雅佳 任梦娟 王平 陈子杰 周奇[2] 柯学[4] 李国保[4] 郭强强 陈耀龙[5] 卢水华 Wu Shouyuan;Lan Hui;Liu Yunlan;Sun Yajia;Ren Mengjuan;Wang Ping;Chen Zijie;Zhou Qi;Ke Xue;Li Guobao;Guo Qiangqiang;Chen Yaolong;Lu Shuihua(School of Public Health,Lanzhou University,Lanzhou 730000,China;Evidence-Based Medicine Center,School of Basic Medical Sciences,Lanzhou 730000,China;The First School of Clinical Medical,Lanzhou University,Lanzhou 730000,China;Department of Lung Disease,Shenzhen Third People′s Hospital,The Second Affiliated Hospital,Southern University of Science and Technology,Shenzhen 518112,China;Research Unit of Evidence-Based Evaluation and Guidelines,Chinese Academy of Medical Sciences(2021RU017),School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学公共卫生学院,兰州730000 [2]兰州大学基础医学院循证医学中心,兰州730000 [3]兰州大学第一临床医学院,兰州730000 [4]深圳国家感染性疾病临床医学研究中心深圳市第三人民医院,深圳518112 [5]中国医学科学院循证评价与指南研究创新单元(2021RU017)兰州大学基础医学院,兰州730000

出　　处：《中华结核和呼吸杂志》2023年第8期760-773,共14页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的通过对国内外重症肺结核研究进行汇总分析,梳理重症肺结核的定义及其纳入标准。方法计算机系统检索Medline、The Cochrane Library、Web of Science、Epistemonikos、Embase、中国知网、万方数据库和中国生物医学文献数据库,搜集在2017—2022年发表的研究对象为重症肺结核患者的研究。检索采用主题词与自由词结合的方式进行。检索词包括:结核、重症、呼吸衰竭、气胸、多器官功能衰竭、肺源性心脏病。提取纳入研究中的重症肺结核相关的定义及纳入标准。结果从上述数据库中共获取19981篇文献,最终共纳入100篇文献,共涉及8309例重症肺结核患者。共8篇(8.00%)研究明确提及重症肺结核的定义,共53篇(53.00%)研究明确了重症肺结核患者的纳入标准。共提取到5种定义和30种纳入标准。纳入研究所关注的重症肺结核患者相关的结局指标中,共有132种二分类变量,113种连续型变量。结论重症肺结核的定义和诊断标准尚不明确,亟须制订明确的定义及诊断标准,帮助指导临床实践。ObjectiveTo clarify the definition of severe pulmonary tuberculosis and its inclusion criteria by summarizing and analyzing the studies of severe pulmonary tuberculosis(TB).MethodsA systematic search of Medline(via PubMed),Cochrane Library,Web of Science,Web of Science,Epistemonikos,Embase,CNKI,WanFang database,and CBM database was conducted to collect studies published between 2017 and 2022 on patients with severe pulmonary TB.Searches were performed using a combination of subject terms and free words.The search terms included:tuberculosis,severe,serious,intensive care,critical care,respiratory failure,mechanical ventilation,hospitalization,respiratory distress syndrome,multiple organ failure,pulmonary heart disease,and pneumothorax.The definitions and inclusion criteria for severe pulmonary TB in the included studies were extracted.ResultsA total of 19981 studies were identified and 100 studies were finally included,involving 8309 patients with severe pulmonary TB.A total of 8(8.00%)studies explicitly mentioned the definition of severe pulmonary TB,and 53(53.00%)studies clearly defined the inclusion criteria for patients with severe pulmonary TB.A total of 5 definitions and 30 inclusion criteria were extracted.A total of 132 dichotomous variables and 113 continuous variables were included in the outcome indicators related to patients with severe pulmonary TB of concern in the studies.ConclusionsThe definition and diagnostic criteria for severe TB are unclear,and there is an urgent need to develop a clear definition and diagnostic criteria to guide clinical practice.

关 键 词：结核 肺 诊断 定义 概况性评价 

分 类 号：R521[医药卫生—内科学]