[去急诊室后诊断为肺结核]。]

Kekkaku : [Tuberculosis] Pub Date : 2016-05-01
Takehiro Yajima, Daisuke Jingu, Satoshi Ubukata, Makoto Shoji, Hiroshi Takahashi
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摘要

我们的目的是评估急诊室(ER)确诊结核病患者的临床特征。[方法]对老年患者进行回顾性研究;在1980年4月至2015年3月期间住院16年,并被诊断患有结核病。我们比较了急诊患者和非急诊患者的临床特征和结核类型。我们还比较了有呼吸道症状和无呼吸道症状的急诊患者延迟诊断结核病的发生率。我们比较了急诊科和非急诊科患者的结核病偶遇率和结核病诊断时间。【结果】共纳入255例患者,其中ER患者54例,非ER患者201例。急诊患者的平均年龄J高于非急诊患者(71.7?16.3年vs. 63.3年,20.3年,p=0.006)。到急诊室就诊的原因包括腰椎骨折、急性心肌梗死、出血性胃溃疡、脑梗死和一氧化碳中毒等急症,需要立即治疗。由于优先考虑紧急治疗,无呼吸道症状的ER患者(n=21)诊断结核病的时间约为有呼吸道症状患者(n=33)的3倍。救护车运送病人的结核病接诊率为1/1,800,门诊急症病人的结核病接诊率为1/22,000。由救护车运送的病人诊断结核病的时间比急诊门诊病人或非急诊室病人大约长4-6天。[结论]医生应努力排除所有急诊病人肺结核的可能性,即使在更紧急的临床情况下也是如此。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[[TUBERCULOSIS DIAGNOSIS FOLLOWING A VISIT TO THE EMERGENCY ROOM].]

We aimed to evaluate the clinical char- acteristics of patients admitted to the emergency room (ER) and diagnosed with tuberculosis. [Method] We conducted a retrospective study of patients aged ; 16 years admitted to the hospital between April 1980 and March 2015 and diagnosed with tuberculosis. We com- pared patient clinical characteristics and type of tuberculosis between ER and non-ER patients. We also compared the incidence of delayed diagnosis of tuberculosis between ER patients with and without respiratory symptoms. We compared the tuberculosis encounter rate and the time to diagnosis of tuberculosis in ER and non-ER patients. [Results] A total of 255 patients, including 54 ER and 201 non-ER patients were enrolled in this study. The average age J was higher in ER patients than in non-ER patients (71.7? 16.3 vs. 63.3 ?20.3 years, p=0.006). The reasons for visiting the ER included acute conditions such as fracture of the lumbar spine, acute myocardial infarction, hemorrhagic gastric ulcer, brain infarction, and carbon monoxide intoxication, requiring immediate treatment. The time to diagnosis of tuberculosis in ER patients without respiratory symptoms (n=21) was approximately three times longer than that in patients with respiratory symptoms (n=33) as urgent treatment is priori- tized. The tuberculosis encounter rate was 1/1,800 for pa- tients transported by ambulance and 1/22,000 for emergency outpatients. The time to diagnosis of tuberculosis for patients transported by ambulance was approximately 4-6 days lon- ger than that for emergency outpatients or non-ER patients. [Conclusion] Physicians should seek to rule out the possi- bility of tuberculosis in all patients admitted to the ER, even where more urgent clinical conditions are prioritized.

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