脊柱结核并发HIV/AIDS患者诊断及治疗专家共识(第2版)  

Expert consensus on diagnosis and treatment of spinal tuberculosis with HIV/AIDS(2nd Edition)

作　　者：《脊柱结核并发HIV/AIDS患者诊断及治疗专家共识》编写组 中国防痨协会骨关节结核专业分会 中国性病艾滋病防治协会艾滋病外科专业委员会 中国西部骨结核联盟 中国华北骨结核联盟 秦世炳[2] 蒲育 张强[4] 范俊[2] 何敏 Expert Consensus on the Diagnosis and Treatment of Spinal Tuberculosis Combined with HIV/AIDS Patients Group;the Joint Tuberculosis Professional Branch of Chinese Antituberculosis Association;AIDS Surgery Professional Committee of Chinese Association of STD and AIDS Prevention and Control;the Western China Bone Tuberculosis Alliance;the North China Bone Tuberculosis Alliance;Qin Shibing;Pu Yu;Zhang Qiang

机构地区：[1]不详 [2]首都医科大学附属北京胸科医院 [3]成都市公共卫生临床医疗中心 [4]首都医科大学附属北京地坛医院

出　　处：《结核与肺部疾病杂志》2025年第2期158-168,共11页Journal of Tuberculosis and Lung Disease

基　　金：北京市科技计划课题(D141107005214002);成都市卫生健康委员会科研课题(2022072)。

摘　　要：脊柱结核并发HIV/AIDS患者因免疫功能低下,治疗的难度成倍增加。为规范脊柱结核并发HIV/AIDS患者的诊疗流程,使更多同行了解此类疾病治疗细节,并在治疗时有据可依,中国防痨协会骨关节结核专业分会、中国西部骨结核联盟、中国华北骨结核联盟、《中国防痨杂志》编辑委员会于2020年5月共同制定并发布了《脊柱结核并发HIV感染/AIDS患者诊断及治疗专家共识》。该共识从脊柱结核并发HIV/AIDS患者的流行病学背景开始论述,对其常见临床表现、实验室检查及诊断标准、药物及手术治疗方法、脊柱结核并发HIV/AIDS患者手术过程中的职业暴露和注意事项,以及研究方向等进行了深入的阐述与讨论。在第1版共识的基础上,结合我国脊柱结核并发HIV/AIDS患者诊断及治疗的经验和方法,以及国外诊断和治疗相关研究成果,本共识编写组共同拟定了《脊柱结核并发HIV/AIDS患者诊断及治疗专家共识(第2版)》,重点介绍近5年来脊柱结核合并HIV/AIDS的流行病学特征、患者术前抗病毒治疗的新进展、耐药结核病的抗结核治疗方案、微创手术治疗脊柱结核合并HIV/AIDS的进展,以及加速康复外科理念在脊柱结核并发HIV/AIDS诊治中的应用前景,以供临床医师对脊柱结核并发HIV/AIDS患者进行精准诊断、合理治疗。Patients with spinal tuberculosis co-infected with HIV/AIDS are profoundly immunocompromised,significantly complicating their clinical management.To establish standardized protocols for diagnosing and treating this dual pathology,thereby enhancing clinical understanding and providing evidence-based treatment guidelines,the Joint Tuberculosis Professional Branch of Chinese Antituberculosis Association,in collaboration with the Western China Bone Tuberculosis Alliance,the North China Bone Tuberculosis Alliance,and the Editorial Board of Chinese Journal of Antituberculosis,formulated and released the Expert consensus on the diagnosis and treatment of patients with spinal tuberculosis complicated with HIV/AIDS in May 2020.The consensus opens with an overview of the epidemiological context of spinal tuberculosis complicated by HIV/AIDS.It provides a detailed discussion on the common clinical manifestations,laboratory diagnostic criteria,as well as pharmacological and surgical treatment options.Furthermore,it addresses critical aspects such as occupational exposures,necessary precautions during surgery,and outlines future research directions for the management of spinal tuberculosis complicated by HIV/AIDS.Building upon the first edition of the consensus,and incorporating both the clinical experience and diagnostic and therapeutic approaches for spinal tuberculosis complicated by HIV/AIDS in China,as well as relevant international research findings,the consensus writing group has jointly developed the second edition of the Expert consensus on diagnosis and treatment of spinal tuberculosis with HIV/AIDS.This updated version highlights recent epidemiological trends over the past five years,advances in preoperative antiviral therapy,and the evolving anti-tuberculosis treatment regimens for drug-resistant tuberculosis.The consensus also discusses the advancements in minimally invasive surgery for the treatment of spinal tuberculosis complicated by HIV/AIDS,as well as the potential application of accelerated recovery surger

关 键 词：结核 脊柱 HIV感染 获得性免疫缺陷综合征 共病现象 总结性报告(主题) 

分 类 号：R529.2[医药卫生—内科学] R512.91[医药卫生—临床医学]