林栋++++++石罗君++++++冼秀玲++++++徐奎++++++黄永光++++++赵权++++++黄家杰++++++包家福++++++马自传++++++张庆亚　覃倪++++++黄波贞++++++莫实德++++++吴尚文

[摘要] 目的 分析广西沿海沿边区域务工人员新发肺结核临床及影像学特征，为预防控制肺结核的流行与传播提供参考。方法 选择2012年1月—2014年1月该院收治的80例患者为研究对象，其中40例务工新发肺结核为观察组，40例防城港常住人员新发肺结核为对照组，分析病历资料及治疗结果。结果 观察组平均年龄（27.65±3.21）岁、文化程度（小学及以下2例，初中12例，高中25例，大学及以上1例）、失访率30.00%、治愈率为71.43%，对照组平均年龄为（54.36±6.12）岁，文化程度（小学及以下3例，初中15例，高中16例，大学及以上6例），失访率12.5%，治愈率为88.57%，两组数据比较差异有统计学意义（P<0.05）；观察组患者Ⅲ型38例，痰菌阳性率为62.5%，复治病例8例，双侧肺受累25例，中下肺野病变30例，病变累及肺野数目2个及以上32例，对照组Ⅲ型32例，痰菌阳性率35.00%，复治病例2例，双侧肺受累17例，中下肺野病变22例，病变累及肺野数目2个及以上25例，两组数据比较差异有统计学意义（P<0.05 ）。结论 外出务工人员新发肺结核表现为男性高于女性、多发于30岁以下、文化程度较低的流行病学特征，临床表现为Ⅲ型肺结核且复始病例多、治疗效果差等，影像学表现为病变分布广泛、病变累及数目多等特征。卫生行政部门应制定相应政策，以预防和控制务工人员肺结核病的流行。

[关键词] 结核病；务工人员；流行病学；影像学特征

[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742（2015）01（a）-0023-04

Study of the Clinical and Imaging Characteristics of New Pulmonary Tuberculosis in the Migrant Workers in Guangxi Coastal Area and Border Region

LIN Dong SHI Luojun XIAN Xiuling XU Kui HUANG Yongguang ZHAO Quan HUANG Jiajie BAO Jiafu MA Zichuan ZHANG Qingya QIN Ni HUANG Bozhen MO Shide WU Shangwen

Department of Medical Imaging， Fangchenggang Hospital of Traditional Chinese Medicine， Fangchenggang， Guangxi Zhuang Autonomous Region， 538021， China

[Abstract] Objective To analyze the clinical and imaging features of new pulmonary tuberculosis in the migrant workers in Guangxi coastal area and border region so as to provide a reference for controlling and preventing the prevalence and spread of pulmonary tuberculosis. Methods 80 cases admitted to this hospital from Jan 2012 to Jan 2014 were selected as the subjects 40 migrant workers with new pulmonary tuberculosis were selected as the observation group， and 40 permanent residents of Fangchenggang with new pulmonary tuberculosis were selected as the control group. And their medical records and treatment results were analyzed. Results In the observation group， the average age was （27.65±3.21） years old， 2 cases had primary school education or below， 12 cases had junior middle school education， 25 cases had high school education， 1 case had university education or above， the loss rate was 30.00%， the cure rate was 71.43%； in the control group， the average age was （54.36±6.12） years old， 3 cases had primary school education or below， 15 cases had junior middle school education， 16 cases had high school education， 6 cases had university education or above， the loss rate was 12.5%， the cure rate was 88.57%， the differences between the groups were statistically significant （P<0.05）. In the observation group， there were 95 cases with type III， the positive rate of sputum bacteria was 62.5%， 8 retreatment cases， 25 cases with bilateral lung involvement， 30 cases with middle and lower lung field lesions， 32 cases with lesions involving 2 or more lung fields； in the control group， there were 32 cases with type III， the positive rate of sputum bacteria was 35.00%， 2 retreatment cases， 17 cases with bilateral lung involvement， 22 cases with middle and lower lung field lesions， 25 cases with lesions involving 2 or more lung fields， the differences in the data between the two groups were statistically significant（P<0.05）. Conclusion The new pulmonary tuberculosis in the migrant workers presents the epidemiologic features that males and those people have low education under 30 years old have a higher incidence of the disease， the clinical manifestations are characterized by type III pulmonary tuberculosis， many retreatment cases， poor treatment effect and so on； the imaging manifestations show wide distribution of lesions， too many sites involved by the lesions and so forth. Administrative department of public health should formulate corresponding policies for controlling and preventing the spread of the disease.

[Key words] Tuberculosis； Migrant workers； Epidemiology； Imaging features

肺结核是一种经过呼吸道传播的慢性传染性疾病，临床主要表现为发热、盗汗、纳差、乏力为主的结核中毒症状以及咳嗽、咳痰、咯血为主的呼吸系统症状。我国每年新发肺结核病人130万人，每年死亡肺结核患者达13万，耐药肺结核患者高达46%，为“特别引起警示的国家和地区”之一[1]。流动人口（劳务人员流动）在肺结核的传播中起着不容忽视的作用，也被称为“结核病流行加速剂”[2]。该研究以此为背景，探讨2012年1月—2014年1月广西沿海沿边区域务工人员新发肺结核临床及影像学特征，旨在为广西沿海沿边区域务工人员结核病预防与控制提供参考，现报道如下。

1 资料与方法

1.1 一……