2018－2020年9家结核病定点医院肺外结核病住院患者特征分析

刘燕飞; 李涛; 夏愔愔; 祝贺; 赵雁林; 陈伟

doi:10.3784/jbjc.202212260551

2018－2020年9家结核病定点医院肺外结核病住院患者特征分析

Characteristics of nine extra-pulmonary tuberculosis inpatients in nine designated tuberculosis hospitals, 2018−2020

摘要

摘要:
目的分析住院肺外结核病患者的流行病学特征，为肺外结核病的防治政策和措施制定提供科学依据。
方法采用回顾性调查的方法，从全国东中西部共选取9家结核病定点医疗机构，利用医院信息系统（HIS）收集出院第一诊断为“肺外结核”和“结核性胸膜炎”患者的人口学特征和临床特征等。采用频数、构成比和中位数对患者的相关资料进行描述性统计分析；采用χ²检验比较组间分布是否具有差异。
结果本研究共纳入3451例肺外结核病患者，肺外结核病患者年龄中位数M（P₂₅，P₇₅）为44（29，59）岁；男、女性别比例为1.41∶1；农、牧民患者有1615例（46.80%）。结核性胸膜炎、淋巴结结核和骨关节结核分别有689例（19.97%）、434例（12.58%）和427例（12.37%）。肺外结核合并肝胆疾病、肾脏疾病和营养不良分别有533例（15.44%）、354例（10.26%）和258例（7.48%）。从临床特征分析，入院前病情明确的患者有1973例（57.17%），46.28%（1597例）的患者接受手术治疗。住院天数中位数为17d。从肺外结核病患者的医保类型分析，城镇居民医保患者有1244例（占36.05%）；全自费患者有398例（占11.53%）。
结论肺外结核病住院患者主要以男性、中青年和农（牧）民为主体，以结核性胸膜炎、淋巴结结核和骨关节结核最常见。

Abstract:
Objective To analyze the epidemiological characteristics of hospitalized patients with extra-pulmonary tuberculosis (TB) in China, and provide scientific basis for the formulation of policies and measures for the prevention and treatment of extra-pulmonary TB.
Methods A retrospective survey was conducted in 9 designated tuberculosis hospitals selected in eastern, central and western China. The information about demographic and clinical characteristics of the hospitalized patients with the diagnosis of extra-pulmonary TB or tuberculous pleuritis at discharge were collected from Hospital Information System. Descriptive statistical analyses on the patients’ information were performed by using frequency, constituent ratio and median, and χ² test was used to compare the differences in distributions among groups.
Results A total of 3451 patients with extra-pulmonary TB were included in the study. The median age of the patients was 44（29, 59）years. The male to female ratio of the patients was 1.41∶1. In the extra-pulmonary TB included, 1615 (46.80%) were farmers and herders. Tuberculous pleurisy, lymph node TB and bone and joint TB cases accounted for 19.97% (689 cases), 12.58% (434 cases) and 12.37% (427 cases) respectively. Extra-pulmonary TB complicated with hepatobiliary disease, renal disease and malnutrition were found in 533 cases (15.44%), 354 cases (10.26%) and 258 cases (7.48%) respectively. A total of 1973 patients (57.17%) had clear medical conditions before admission, and 1597 patients (46.28%) had surgical operation. The median length of hospitalization was 17.00 days. The analysis on the type of health insurance for patients with extra-pulmonary TB indicated that 1244 patients (36.05%) had urban residents' health insurance; and 398 patients (11.53%) paid for the medical treatment by themselves.
Conclusion The hospitalized patients with extra-pulmonary TB were mainly males, young and middle-aged people and farmers (herdsmen), and tuberculous pleurisy, lymph node TB and bone and joint TB were the most common types.

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