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目的通过总结先天性结核的临床特点,回顾相关文献资料,提高临床医师对先天性结核的认识,减少该病的误诊、漏诊。方法回顾性分析我院1例先天性结核患儿临床特点和辅助检查的资料,结合以往先天性结核的文献报道,总结该病的临床诊断思维和治疗方法。结果共检索到相关文献19篇,其中个案报道14篇,资料较完整的文献共10篇,包括12例患儿。本例及文献报道共13例患儿平均发病日龄(18.0±10.7)天;母亲围产期存在明确结核病史10例(76.9%),患儿发热11例(84.6%),肝脾大12例(92.3%),血沉增快1例(7.7%);13例患儿胸部X线片均有阳性改变(100%);11例患儿接受抗结核治疗(84.6%);死亡8例,病死率61.5%。结论先天性结核在新生儿少见,临床无特异性表现,病情进展快,病死率高。应提高对先天性结核的认识,做到早期诊断,早期治疗,改善患儿预后。
Objective To summarize the clinical features of congenital tuberculosis, review the relevant literature and information to improve clinicians understanding of congenital tuberculosis and reduce the misdiagnosis and misdiagnosis of the disease. Methods A retrospective analysis of 1 case of children with congenital tuberculosis in our hospital clinical features and auxiliary examination of information, combined with previous reports of congenital tuberculosis, summarize the clinical diagnosis of the disease thinking and treatment. Results A total of 19 articles were retrieved, of which 14 cases were reported and 10 more complete documents were included, including 12 children. The average age of onset was (18.0 ± 10.7) days in 13 cases reported in this case and in the literature. There were 10 cases (76.9%) with definite history of tuberculosis in the mother’s perinatal period, 11 cases (84.6%) with fever in children and 12 cases of hepatosplenomegaly (92.3%) and erythrocyte sedimentation rate (1) (7.7%). Thirteen children had positive changes in chest radiography (100%), 11 children received antituberculous therapy (84.6%), 8 died, Case fatality rate of 61.5%. Conclusions Congenital tuberculosis is rare in newborns and has no specific clinical manifestations. The disease progresses rapidly and the case fatality rate is high. Should increase awareness of congenital tuberculosis, so early diagnosis, early treatment, improve the prognosis of children.