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目的探讨HIV/AIDS在综合性医院的临床流行病学情况及防治对策。方法回顾分析2006-2009年某综合医院收治HIV/AIDS患者的临床资料。结果该院初筛阳性并经省CDC确诊共133例,男性102例,女性31例,平均42.58岁。87.5%HIV/AIDS为临床科室收治病例,HIV/AIDS收治病例有逐年增多趋势。其中首诊发现病例最多的科室是呼吸内科(30.08%),另有传染科、血液科、消化内科、神经内科等,内科总计发现病例102例(76.69%)。本组AID中,主要临床表现为肺部疾病58例(55.24%),消化疾病38例(36.19%),神经系统表现16例(15.24%),其他表现21例。肺部表现除主要为CT呈肺部毛玻璃样改变(GGO),及/或肺炎,肺结核,尚有肺门、纵隔淋巴结肿大,以及肺内肿瘤样改变。神经系统改变表现为颅内占位或低密度影像改变、颅内感染。消化系统表现除常见的腹泻、消瘦外,常有口腔霉菌、食道霉菌、肠道霉菌、肝硬化和腹腔淋巴结肿大。住院死亡10例,与肺部感染有关;但多数病人及家属,在初诊确定后选择自动出院,仅少数患者选择积极应对。结论综合性医院将面对HIV/AIDS疫情的新课题,综合性医院艾滋病病例逐年增加是艾滋病由重点人群向一般人群扩散的重要表现。应提高对艾滋病复杂病情的认识,加强主动筛查和输血前检查。
Objective To explore the clinical epidemiology of HIV / AIDS in general hospitals and its control strategies. Methods The clinical data of HIV / AIDS patients in a general hospital from 2006 to 2009 were retrospectively analyzed. Results The hospital was screened positive and confirmed by the provincial CDC a total of 133 cases, 102 males and 31 females, average 42.58 years. 87.5% of HIV / AIDS cases were treated in clinical departments, and the cases of HIV / AIDS were increasing year by year. Among them, the most frequently diagnosed cases were respiratory medicine (30.08%), infectious diseases, hematology, gastroenterology and neurology. The total number of cases was found in 102 cases (76.69%). AID in this group, the main clinical manifestations of lung disease in 58 cases (55.24%), digestive diseases in 38 cases (36.19%), the nervous system manifestations in 16 cases (15.24%), the other 21 cases. In addition to pulmonary manifestations were mainly CT showed pulmonary frog-like changes (GGO), and / or pneumonia, tuberculosis, there are hilar, mediastinal lymph nodes, and lung tumor-like changes. Nervous system changes showed intracranial space or low-density imaging changes, intracranial infection. Digestive system performance in addition to common diarrhea, weight loss, often oral mold, esophageal mold, intestinal mold, cirrhosis and abdominal lymph nodes. In-hospital deaths in 10 cases, and lung infection; but most patients and their families, after the initial diagnosis of the choice of automatic discharge, only a small number of patients choose to actively respond. Conclusion The general hospital will face a new issue of HIV / AIDS epidemic. The yearly increase of HIV / AIDS in general hospitals is an important manifestation of the spread of AIDS from the key population to the general population. Awareness of the complicated situation of AIDS should be raised and active screening and pre-transfusion tests should be strengthened.