儿童和青少年结核病检测和诊断中的跨学科互动问题:文献回顾和评论

Q4 Medicine
E. S. Ovsyankina, L. V. Panova, I. N. Zakharova
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引用次数: 0

摘要

肺结核医生和儿科医生在结核病的发现和诊断问题上的跨学科互动为缩短诊断过程的持续时间和早期识别疾病进展提供了基础。本综述和评论的目的是使儿科医生对初级卫生保健(PHC)机构中儿童和青少年结核病的检测和诊断知识系统化,以改进诊断过程。我们对目前关于初级保健设施中结核病检测和诊断的指令和方法学文件、文章进行了分析和系统化。强调在大规模和选择性筛查中,皮肤免疫试验(使用纯化蛋白衍生物(PPD)-L的5个结核菌素单位(TU)的Mantoux试验和重组结核过敏原(RTA)试验)对形成结核病高危人群和发现疾病的重要性。在父母/法定代理人或患者本人拒绝免疫皮肤试验的情况下,介绍了医生根据现行指导性文件和法律采取的行动。确定儿科医生在结核病的检测、诊断和鉴别诊断问题上需要跨学科互动的立场是明确明确的。诊断途径始于在初级保健设施中形成结核病高危人群,并在出现与结核病类似的临床症状时向儿科医生寻求医疗帮助。在临床症状与结核病相似的患者寻求医疗帮助时,特别注意对疾病的检测,并介绍了错过的早期诊断机会。提供预测因子,使儿科医生怀疑结核病,并及时将患者转介给肺结核医生以确认/排除疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Issues of interdisciplinary interaction during detection and diagnosis of tuberculosis in children and adolescents: a literature review and comments
Interdisciplinary interaction between phthisiatricians and pediatricians on the issues of detection and diagnosis of tuberculosis provides basis for the reduction of duration of the diagnostic process and the early identification of disease progression. The purpose of this review and comments is to systematize the knowledge of pediatricians about the detection and diagnosis of tuberculosis in children and adolescents in primary health care (PHC) facilities to improve the diagnostic process. We have performed an analysis and systematization of the current directive and methodological documents, articles on the detection and diagnosis of tuberculosis in PHC facitlities. The significance of skin immunological tests (Mantoux test using 5 tuberculin units (TU) of purified protein derivative (PPD)-L and a test with recombinant tuberculosis allergen (RTA)) during mass and selective screening to form groups at high risk for Tuberculosis and detect the disease is emphasized. The doctor’s actions based on the current guiding documents and laws are presented for cases when parents/legal representatives or the patient himself refuses from immunological skin tests. Positions that determine the need for interdisciplinary interaction for pediatricians on the issues of detection, diagnosis and differential diagnosis of tuberculosis are clearly articulated. The pathway to diagnosis begins with the formation of groups at high risk for tuberculosis in PHC facilities and with seeking medical help from a pediatrician in the presence of clinical signs similar to those of tuberculosis. Particular attention is paid to the detection of the disease when patients with clinical symptoms similar to those of tuberculosis seek medical help, and the missed opportunities for its early diagnosis are presented. Predictors allowing pediatricians to suspect tuberculosis and promptly refer a patient to a phthisiatrician to confirm / exclude the disease are provided.
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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