关键词: 关键词：结核, 肺/诊断, 结核, 肺/药物疗法

Abstract: ObjectiveTo analyse clinical characteristics of hematogenous disseminated pulmonary tuberculosis. MethodsWe analyzed retrospectively the data of clinical features, treatment and prognosis of 362 patients with hematogenous disseminated pulmonary tuberculosis who hospitalized in our hospital from 1998 to 2007. ResultsMost patients with hematogenous disseminated pulmonary tuberculosis were young and they accounted for 62.0%. The elderly patients showed an upward tendency and they accounted for 21.0%. The fever accounted for 86.1% in clinical symptom. The respiratory symptom mainly included cough, fatigue, tachypnea, night sweat and chest pain. The symptoms of headache, nausea and vomiting would be seen patients complicated with tubercular meningitis. The time of clinical confirmed diagnosis: patients confirmed diagnosis within 30 days accounted for 50.3%, a few patients were diagnosed over four months. The rate of sputum bacilli positive was 37.8%,the positive reaction of PPD test 58.6%, the positive rate of serum antitubercular antibody 44.8%. The patients with acute hematogenous disseminated pulmonary tuberculosis accounted for 68.5%, the patients with subacute and chronic hematogenous disseminated pulmonary tuberculosis 31.5%. Those patients with typical military nodes in X-ray accounted for 68.5%, the patients complicated with extrapulmonary tuberculosis 40.0%. The non-tuberculosis complication accounted for 68.2%. Antituberculosis treatment with 4 or 5 drugs and the treatment for non-tuberculosis complication were given at the same time.Except two deaths due to cerebral hernia, most patients were improved. ConclusionsHematogenous disseminated pulmonary tuberculosis is a kind of critical pulmonary tuberculosis with serious symptom, especially when complicated with tuberculosis in other viscera. The effective antituberculosis treatment should be given in time for those patients with hematogenous disseminated pulmonary tuberculosis and extraplumoary tuberculosis. Treatment for non-tuberculosis complication is also performed properly. Adjuvant and supportive care including immunopotentiators maybe improve symptoms for these patients.

Key words: tuberculosis,pulmonary/diagnosis, tuberculosis,pulmonary/drug therapy