肺结核并发肠梗阻患者的危险因素研究

摘要/Abstract

摘要： 目的: 探讨肺结核患者并发肠梗阻的相关危险因素。方法: 选取2015年1月至2021年1月在本院住院的20例肺结核并发肠梗阻患者作为观察组,同期住院的35例肺结核患者作为对照组。收集两组患者的一般资料、病史、实验室指标、影像学资料、临床表现及并发症等临床资料,进行回顾性分析。结果: 观察组患者年龄、男性比例、体质量、痰菌抗酸杆菌比例、结核病程、肺结核类型为血行播散性肺结核、继发性肺结核、结核性胸膜炎比例、长期使用阿米卡星针、链霉素针等氨基糖苷类抗生素及皮质类固醇药物比例、合并糖尿病比例高于对照组,观察组患者血红蛋白水平低于对照组,两组差异有统计学意义（P<0.05）;logistic回归分析显示,年龄、男性、体质量、痰菌抗酸杆菌、结核病程、结核类型、用药史、合并糖尿病、血红蛋白水平低是肺结核患者并发肠梗阻的独立危险因素。两组患者腹部CT影像特征具有明显的差异,其中,观察组患者CT影像可见梗阻点,而对照组患者CT影像正常。结论: 年龄、男性、体质量、痰菌抗酸杆菌、结核病程、结核类型、用药史、合并糖尿病、血红蛋白水平低是肺结核患者并发肠梗阻的重要危险因素,基于这些危险因素,需控制年龄相关因素、注意性别差异、控制体质量、控制结核病和治疗、合理用药、糖尿病管理、血红蛋白水平管理、早期症状识别和处理,才能预防或减少肠梗阻的发生。

关键词: 肺结核, 并发, 肠梗阻, 相关危险因素, 回归分析

王芳芳, 陈贤豪, 卢姝姝, 李慧秀. 肺结核并发肠梗阻患者的危险因素研究[J]. 中国防痨杂志, 2025, 47(S2): 119-122.

参考文献

[1] 张继萍,申晓晓,李霞,等.微生态制剂联合肠内营养治疗2型糖尿病并发肺结核的效果分析[.河北医药,2024,46(3):392-395.
[2] Wang J,Zhang C,Zhang G,et al.Holmium laser and stone basketing:an innovative treatment for gallstone sigmoid obstruction caused by cholecystocolonic fistula.Quantitative imaging in medicine and surgery,2024,14(12):9730-9737.
[3] Belete D,Amare A,Andualem T,et al.Prevalence of Intestinal Parasitic Infections and Associated Factors among Presumptive Pulmonary Tuberculosis Patients at Debre Tabor Referral Hospital,South Gondar,Northwest Ethiopia:A Cross-Sectional Study.Journal of parasitology research,2024,20248993666-8993666.
[4] Hong W,Zhang L,Yu Z,et al.Intestinal obstruction following antituberculosis therapy in a patient with pancreatic carcinoma and pulmonary tuberculosis:a case report.Journal of medical case reports,2024,18(1):495.
[5] 玉明柳,温玫,龚贝贝.品管圈管理对降低肺结核有创机械通气患者肠内营养相关误吸发生率的效果.现代医药卫生,2023,39(17):3010-3015.
[6] Qiqi Z,Xianyi Z,Kehong Z,et al.The gut and lung microbiota in pulmonary tuberculosis:susceptibility,function,and new insights into treatment.Expert review of anti-infective therapy,2023,21(12):1355-1364.
[7] Zhao J,Zhao X,Hu D,et al.Chinese expert consensus on magnetic resonance enterography of the small intestine and standardized reporting guidelines.Chinese Journal of Academic Radiology,2024,8(1):1-9.
[8] 刘佳林,赵志芳,陈晨,等.原发性肠结核穿孔诱发血行播散型肺结核1例.现代消化及介入诊疗,2022,27(10):1363-1364.
[9] 郑广平,罗杰棋,鲍晓慧,等.肠结核的临床影像诊断及与克罗恩病的鉴别诊断.新发传染病电子杂志,2022,7(3):90-94.
[10] Lao Y,Xu W,Lin H.Evidence-based nursing model for preventing early postoperative intestinal obstruction after radical gastrectomy:Impact on recovery and patient satisfaction.Asian journal of surgery,2024,48(2):1061-1062.
[11] 李康,柴英辉,白光亮,等.肺结核与肠道菌群相关性的研究进展.中国防痨杂志,2021,43(11):1210-1215.
[12] Yohannes Z,Meseret H,Markos A,et al.Intestinal helminth co-infection and associated factors among pulmonary tuberculosis patients in Africa and Asia:a systematic review and meta-analysis.BMC infectious diseases,2023,23(1):739-739.
[13] 郭鑫,微生态制剂联合肠内营养辅助治疗复治菌阳肺结核的研究.黑龙江省传染病防治院,2020-12-30.
[14] 周起环,李畅蕾,李拥兰,等.耐多药肺结核伴营养不良患者肠内营养支持治疗效果分析.实用妇科内分泌电子杂志,2020,7(36):164,168.
[15] Rubeshan P,Kogieleum N,Anushka N,et al.The impact of enteral feeding and therapeutic monitoring of rifampicin with dose escalation in critically ill patients with tuberculosis.International Journal of Infectious Diseases,2023,126174-180.
[16] Li J,Zhang B,Guo J,et al.Evaluating the efficacy of low-kV X-ray intraoperative radiotherapy in the treatment of locally advanced rectal cancer:a retrospective cohort study.Quantitative imaging in medicine and surgery,2024,14(12):8538-8550.
[17] 侯双雁,叶婷,黄美金,等.乳清蛋白联合肠内营养制剂对糖尿病合并肺结核患者营养支持的疗效观察.右江医学,2020,48(3):209-212.
[18] 周洁,陆永安,顾凤林.肺结核合并肠结核及脊柱结核一例报道.临床合理用药杂志,2020,13(9):164-166.