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目的总结综合三甲医院内外科确诊艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人(简称HIV/AIDS病人)的临床特点,以提高临床医生对HIV/AIDS病人早期识别和诊治水平。方法回顾性分析南昌大学第二附属医院首次确诊并有完整病历资料的150例HIV/AIDS病人,其中内科102例,外科48例。对病人就诊科室构成、临床症状及内外科确诊时间,白细胞计数、红细胞计数、淋巴细胞绝对值、嗜酸性粒细胞计数进行比较分析。结果 HIV/AIDS病人就诊在综合医院科室分布广泛,内科确诊HIV/AIDS病人呼吸科54例(36.0%),血液科15例(10.0%),神经内科13例(8.7%),消化科9例(6.0%)等。HIV/AIDS病人就诊症状多样化,以发热为主,有60例(40.0%),呼吸系统症状咳嗽52例(34.7%),胸闷36例(24.0%),气喘31例(20.7%);皮肤黏膜损害皮疹5例(3.3%),消化系统腹痛13例(8.7%)等。外科系统病人无症状9例(6.0%),外科术前筛查26例(17.3%)。内科就诊病人淋巴细胞比例低,红细胞计数低及确诊时间长,与外科就诊病人比较具有统计学差异(P<0.05)。结论综合三甲医院HIV/AIDS病人就诊科室多,临床症状多样,内科就诊病人多为AIDS期,且确诊时间较外科时间长,需加强内科就诊病人HIV筛查。
Objective To summarize the clinical features of HIV / AIDS patients and HIV / AIDS patients in the top three hospitals in order to improve the early identification and diagnosis and treatment of HIV / AIDS patients by clinicians. Methods A retrospective analysis of 150 cases of HIV / AIDS patients diagnosed in the Second Affiliated Hospital of Nanchang University with complete medical records was conducted, including 102 cases of internal medicine and 48 cases of surgery. On the composition of the patient department, clinical symptoms and surgical diagnosis of internal and external time, white blood cell count, erythrocyte count, lymphocyte absolute value, eosinophil count comparative analysis. Results There were 54 HIV / AIDS patients (36.0%), 15 Hematology patients (10.0%), 13 Neurology patients (8.7%), 9 Gastroenterology patients (6.0%) and so on. There were 60 (40.0%) cases of fever, 52 cases (34.7%) of cough in respiratory system, 36 cases (24.0%) of chest tightness and 31 cases (20.7%) of asthma in HIV / AIDS patients. Mucosal damage rash in 5 cases (3.3%), digestive system abdominal pain in 13 cases (8.7%) and so on. There were 9 asymptomatic patients (6.0%) in the surgical system and 26 (17.3%) preoperative surgeries. Medical patients with low proportion of lymphocytes, low red blood cell count and diagnosis of a long time, compared with the surgical treatment of patients was statistically significant (P <0.05). Conclusions HIV / AIDS patients in the top three hospitals have many departments and clinical symptoms. Most of the medical patients are AIDS patients, and the diagnosis time is longer than that of the surgical patients. HIV screening in medical patients needs to be strengthened.