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儿童结核病合并症。

COMORBIDITIES AT THE TUBERCULOSIS AMONG CHILDREN.

机构信息

DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE.

出版信息

Wiad Lek. 2021;74(10 pt 1):2433-2438.

Abstract

OBJECTIVE

The aim: To study the structure of clinical forms of tuberculosis (TB) which are combined with the comorbidities, to prevent the development, and to improve the diagnostics of TB among children with nonspecific diseases.

PATIENTS AND METHODS

Materials and methods: A retrospective, selective research of 330 cards of children for the age group from 0 to 15 years old who were treated on local forms of pulmonary and extrapulmonary TB in a specialized pediatric department for the last 30 years was conducted.

RESULTS

Results: Among 92.9 % children with comorbidities, the specific process of respiratory system was detected. Every seventh child has developed generalized forms of pulmonary TB. 43.8 % of children had extrapulmonary TB. In the structure of comorbidities among children with extrapulmonary TB were observed iron deficiency anemia, the diseases of digestive and endocrine systems, malnutrition, cachexia and rickets. The iron deficiency anemia was accompanied by TB of the peripheral LN and TB of the CNS. TB of the rare localization and TB of the CNS were combined with diseases of the digestive system. At pulmonary TB were detected infectious and parasitic diseases. The concomitant pathology of the respiratory and cardiovascular systems was often detected with the TB of intrathoracic LN, and concomitant pathology of the eyes, ears and CNS - with primary tuberculosis complex. The variety of comorbidities and extrapulmonary TB has led to the diagnostic errors and prolonged stay of children in several somatic hospitals.

CONCLUSION

Conclusions: To prevent the development of TB among children with non-specific diseases, it is necessary to strengthen anti-TB measures among them.

摘要

目的

研究合并合并症的肺结核(TB)临床形式的结构,以预防儿童非特异性疾病中 TB 的发展,并改善其诊断。

患者和方法

材料和方法:对过去 30 年来在专门的儿科部门接受局部肺和肺外 TB 治疗的 0 至 15 岁儿童的 330 张卡片进行了回顾性、选择性研究。

结果

在 92.9%合并症的儿童中,发现了特定的呼吸系统过程。每七个孩子中就有一个发展为全身性肺结核。43.8%的儿童患有肺外 TB。在肺外 TB 儿童的合并症结构中,观察到缺铁性贫血、消化系统和内分泌系统疾病、营养不良、消瘦和佝偻病。缺铁性贫血伴有周围 LN 的 TB 和中枢神经系统的 TB。罕见定位的 TB 和中枢神经系统的 TB 与消化系统疾病有关。在肺结核中发现了传染病和寄生虫病。胸部 LN 的 TB 常伴有呼吸和心血管系统的并发病理学,而眼、耳和 CNS 的并发病理学则与原发性结核复合物有关。合并症和肺外 TB 的多样性导致了诊断错误和儿童在几个躯体医院的滞留时间延长。

结论

为了预防非特异性疾病儿童中 TB 的发展,有必要加强他们的抗 TB 措施。

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