合并HIV感染的消化道穿孔患者的临床特点与治疗
Clinical characteristics and management of HIV patients suffering from gastrointestinal perforation
目的 探讨消化道穿孔合并HIV感染患者的诊断、临床特点以及治疗方法.方法 回顾性分析2014年8月至2016年7月成都市公共卫生临床医疗中心普通外科收治的消化道穿孔合并HIV感染17例患者的临床资料.结果 采用X线检查的方法进行诊断,其中穿孔部位位于十二指肠球部5例,胃幽门部3例,回盲部及末端回肠9例.17例患者中7例合并结核感染,2例合并马尔尼菲青霉菌感染,2例死亡.结论 HIV感染者消化道穿孔的病因较普通患者有较大差异,病情急、变化快、病情复杂,一旦确诊应尽早手术治疗.简单有效的手术方式可提高手术治疗的成功率,对HIV感染者需要考虑多重感染的可能性.
更多Objective To investigate the diagnosis,clinical features and treatment of HIV patients complicated with gastrointestinal perforation.Methods There were 17 patients with gastrointestinal perforation and HIV infection,and the clinical data were retrospectively analyzed.Results Abdominal X-ray examination was used to establish the diagnosis,with perforation site at the duodenal bulb in 5 cases,gastric pylorus in 3 cases,ileocecal and terminal ileum in 9 cases.7 cases were co-complicated with tuberculosis infection,1 case with Penicillium mameffei infection,15 were cured and 2 cases died.Conclusions Possible for compromised immunc function,gastrointestinal perforation in HIV patients often found in site less common in otherwise normal cases,and co-infection is common in HIV patients.
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