摘要
目的：评价手术治疗合并胸外科疾患的HIV阳性患者的早期疗效。方法：回顾性分析2004年9月~2006年4月援外期间在莫桑比克马普托中心医院胸外科手术治疗的HIV检测呈阳性而未出现AIDS相关症状患者50例（HIV阳性组）,并选择同期相同疾病构成比的50例HIV检测呈阴性患者作为对照组（HIV阴性组）。并分析两组患者的手术时间、术中出血量、术后引流量、手术后胸腔引流量、手术后肺部和伤口感染率、手术后住院日,以及HIV阳性组CD4计数等临床指标。结果：两组患者手术死亡率在上的差异没有统计学意义;HIV阳性组手术后肺部感染发生率比HIV阴性组高（16%vs 4%,P=0.046）,前者发生手术后肺部感染的危险比后者增加4倍以上（OR=4.571;95%可信区间（1.003,23.654））;HIV阳性患者不同CD4计数手术后肺部感染发生率的差异有统计学意义（P=0.013）;CD4计数与手术后肺部感染发生率呈负相关（R=-0.402;P=0.004）。结论：合并外科疾患的HIV阳性患者手术后并发肺部感染危险增加且与患者CD4细胞计数呈负相关,但不会增加手术死亡率。对与非艾滋病发作期的该类患者,均应积极地治疗。
Objective：To evaluate the early clinic outcomes of the surgical treatment of thoracic disease in HIV-infected patients.Methods：50 HIV-positive patients（HIV-positive group）were underwent thoracic surgery during Sep 2004 to Apr 2006 in the Center Hospital of Maputo,Mozambique.The clinical features,such as operative time,operative blood loss,postoperative drainage quantity,the incidence of operative pulmonary and wound infection,operative mortality,CD4 counts,were retrospective analyzed to evaluate the early outcomes.The other 50 patients without HIV-infected,who were received thoracic surgery during the same period,were control（HIV-negative group）.Results：The operative mortality between two groups was no difference;the incidence of operative pulmonary infection of HIV-positive group was much higher than HIV-negative one;the incidence of operative pulmonary infection was significantly different among different CD4 counts in HIV-infected patients,and this had negative correlation with CD4 counts（R=-0.402;P=0.004）.Conclusion：HIV-infected patients who were received thoracic surgery had higher incidence of operative pulmonary infection,but no significant difference in operative mortality,than HIV-negative ones.
出处
《华西医学》
CAS
2008年第4期706-707,共2页
West China Medical Journal
