Wu S Y, Lan H, Liu Y L, Sun Y J, Ren M J, Wang P, Chen Z J, Zhou Q, Ke X, Li G B, Guo Q Q, Chen Y L, Lu S H
School of Public Health, Lanzhou University, Lanzhou 730000, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou 730000, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2023 Aug 12;46(8):760-773. doi: 10.3760/cma.j.cn112147-20230517-00247.
To clarify the definition of severe pulmonary tuberculosis and its inclusion criteria by summarizing and analyzing the studies of severe pulmonary tuberculosis (TB). A 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. A total of 19 981 studies were identified and 100 studies were finally included, involving 8 309 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. The 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.
通过总结和分析重症肺结核的研究，明确重症肺结核的定义及其纳入标准。对Medline（通过PubMed）、Cochrane图书馆、科学网、Epistemonikos、Embase、中国知网、万方数据库和中国生物医学文献数据库进行系统检索，以收集2017年至2022年发表的关于重症肺结核患者的研究。使用主题词和自由词相结合的方式进行检索。检索词包括：结核病、重症、严重、重症监护、危重症监护、呼吸衰竭、机械通气、住院、呼吸窘迫综合征、多器官衰竭、肺心病和气胸。提取纳入研究中重症肺结核的定义和纳入标准。共识别出19981项研究，最终纳入100项研究，涉及8309例重症肺结核患者。共有8项（8.00%）研究明确提及重症肺结核的定义，53项（53.00%）研究明确界定了重症肺结核患者的纳入标准。共提取出5种定义和30条纳入标准。研究中关注的与重症肺结核患者相关的结局指标共纳入132个二分变量和113个连续变量。重症肺结核的定义和诊断标准尚不明确，迫切需要制定明确的定义和诊断标准以指导临床实践。
