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目的总结接种卡介苗后播散性感染病例临床特点,探讨治疗及护理方法。方法用回顾性调查方法,对汕头市结核病防治所和金平区人民医院2007~2012年收治的接种卡介苗后播散性感染病例归档病历资料,用描述流行病学方法进行研究。采用SPSS13.0统计软件进行统计学分析。结果 2007~2012年共收治28例卡介苗播散性病例,全部病例均符合临床诊断和病原学诊断标准。其中结核感染T细胞检测阳性者25例,占89.2%;淋巴结肿大者26例,占92.9%;肝脾肿大22例,占78.5%,经以方案HRE 1年抗结核治疗,痊愈24例,病灶稳定4例。结论接种卡介苗后应加强监测,对接种卡介苗数周或数月后接种局部脓肿、破溃,结痂延迟伴有发热、咳嗽、肝脾肿大等症状的患儿及时进行相关检查有助于及时诊断。对因免疫功能低下致PPD试验呈阴性者可采用结核感染T细胞检测协助诊断。选用HRE方案进行1年抗结核并辅以增强免疫功能的治疗效果好。
Objective To summarize the clinical features of cases of disseminated infection after BCG vaccination and explore the methods of treatment and nursing. Methods A retrospective survey was conducted to document the medical records of post-BCG-infected cases of BCG vaccinated by TB Control and Shaping People’s Hospital from 2007 to 2012 and to describe the epidemiological data. SPSS13.0 statistical software was used for statistical analysis. Results A total of 28 cases of BCG were disseminated in 2007 ~ 2012, all cases were in line with clinical diagnosis and etiological diagnostic criteria. Among them, 25 cases (89.2%) had positive T cell test for tuberculosis infection, 26 cases (92.9%) had swollen lymph nodes, 22 cases (78.5%) had hepatosplenomegaly, and 24 cases were cured by anti-tuberculosis therapy , 4 cases of stable lesions. Conclusion After BCG vaccination, the surveillance should be strengthened. The timely examination of children with local abscess, ulceration and scab delay accompanied by symptoms such as fever, cough, hepatosplenomegaly and so on after inoculation of BCG for several weeks or months can be helpful to timely diagnosis. For immunodeficiency caused by PPD test was negative for tuberculosis can be used to help detect T cell detection. HRE program for 1 year anti-TB supplemented with enhanced immune function of the treatment effect.