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从儿童结核病的诊断到治疗:单一机构的十年经验

From Diagnosis to Treatment of Pediatric Tuberculosis: Ten Years Experience in a Single Institution.

作者信息

Mete Yesil Ayse, Yalcin Ebru, Ademhan Turhal Dilber, Emiralioglu Nagehan, Dogru Deniz, Ozcelik Ugur, Kiper Nural

机构信息

Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Clin Pediatr (Phila). 2020 May;59(4-5):476-482. doi: 10.1177/0009922820906488. Epub 2020 Feb 22.

DOI:10.1177/0009922820906488
PMID:32088989
Abstract

. To describe the patient characteristics, clinical-epidemiologic-microbiologic profile, and treatment outcomes, and to draw attention to tuberculosis (TB) in Turkey. . A retrospective, descriptive study was undertaken of 93 children aged 0 to 18 years who were admitted to Hacettepe University Pediatric Pulmonology Department for treatment from January 2005 to December 2015. Review of hospital records was performed for all children diagnosed as having TB. . Pulmonary TB was detected in 51.6% of the patients, extrapulmonary involvement in 33.3%, and pulmonary TB with extrapulmonary involvement in 15.1%. The history of contact with an adult with TB was found in 29% of cases. The most common extrapulmonary TB was TB lymphadenitis. The most common symptom was cough followed by fever and night sweats. One fifth of the patients had normal physical examinations at the time of diagnosis. One fifth (20.4%) of the patients had culture, 17.2% had polymerase chain reaction, and 15% had acid-resistant bacillus positivity. In 21.4% of patients with culture growth, at least one anti-TB drug resistance was found. The mean duration of treatment of patients treated according to the national guideline was 8.6 months (range = 6-36 months). Recovery was seen in 91.4% of patients. . The most important way to prevent childhood TB is to fight adult TB through early diagnosis and effective treatment. The presence of contact history must direct us to search for TB. While evaluating children with persisted nonspecific symptoms, TB must be kept in mind even if physical examinations are normal.

摘要

描述患者特征、临床 - 流行病学 - 微生物学概况及治疗结果,并引起对土耳其结核病(TB)的关注。对2005年1月至2015年12月期间因治疗入住哈杰泰佩大学儿科肺病科的93名0至18岁儿童进行了一项回顾性描述性研究。对所有诊断为结核病的儿童的医院记录进行了审查。51.6%的患者检测出肺结核,33.3%有肺外受累,15.1%为肺结核合并肺外受累。29%的病例有与结核病成人接触史。最常见的肺外结核是结核性淋巴结炎。最常见的症状是咳嗽,其次是发热和盗汗。五分之一的患者在诊断时体格检查正常。五分之一(20.4%)的患者进行了培养,17.2%进行了聚合酶链反应,15%抗酸杆菌呈阳性。在培养有生长的患者中,21.4%发现至少一种抗结核药物耐药。按照国家指南治疗的患者平均治疗时间为8.6个月(范围 = 6 - 36个月)。91.4%的患者康复。预防儿童结核病的最重要方法是通过早期诊断和有效治疗来对抗成人结核病。接触史的存在必须促使我们去寻找结核病。在评估有持续非特异性症状的儿童时,即使体格检查正常也必须考虑到结核病。

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