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了解肺结核后肺部疾病的范围及管理:一项全面综述

Understanding the Spectrum and Management of Post-Tuberculosis Lung Disease: A Comprehensive Review.

作者信息

Yadav Sankalp, Rawal Gautam

机构信息

Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND.

Respiratory Intensive Care, Max Super Speciality Hospital, New Delhi, IND.

出版信息

Cureus. 2024 Jun 28;16(6):e63420. doi: 10.7759/cureus.63420. eCollection 2024 Jun.

Abstract

Post-tuberculosis lung disease (PTLD) poses a significant clinical challenge in regions with a high burden of tuberculosis (TB). This review provides a comprehensive overview of PTLD, encompassing its pathogenesis, clinical manifestations, diagnostic modalities, management strategies, long-term outcomes, and public health implications. PTLD arises from residual lung damage following TB treatment and is characterized by a spectrum of pathological changes, including fibrosis, bronchiectasis, and cavitation. Clinical presentation varies widely, from chronic cough and hemoptysis to recurrent respiratory infections, which are oftentimes a diagnostic dilemma. Radiological imaging, pulmonary function tests, and careful consideration of patient history play pivotal roles in diagnosis. Management strategies involve pharmacological interventions to alleviate symptoms and prevent disease progression, which are influenced by the extent of lung damage, comorbidities, and access to healthcare. Rehabilitation programs and surgical options are available for select cases. Prognosis is influenced by the extent of lung damage, comorbidities, and access to healthcare. Prevention efforts through a TB control program and early detection are crucial in reducing the burden of PTLD. This review stresses the importance of understanding and addressing PTLD to mitigate its impact on individuals and public health systems worldwide.

摘要

在结核病(TB)负担较高的地区,肺结核后肺部疾病(PTLD)构成了重大的临床挑战。本综述全面概述了PTLD,涵盖其发病机制、临床表现、诊断方法、管理策略、长期预后以及对公共卫生的影响。PTLD源于结核病治疗后残留的肺部损伤,其特征是一系列病理变化,包括纤维化、支气管扩张和空洞形成。临床表现差异很大,从慢性咳嗽和咯血到反复呼吸道感染,这些情况常常造成诊断难题。放射影像学、肺功能测试以及对患者病史的仔细考量在诊断中起着关键作用。管理策略包括药物干预以缓解症状和预防疾病进展,这受到肺损伤程度、合并症以及医疗可及性的影响。对于特定病例,可采用康复计划和手术选择。预后受肺损伤程度、合并症以及医疗可及性的影响。通过结核病控制计划和早期检测进行预防工作对于减轻PTLD负担至关重要。本综述强调了理解和应对PTLD以减轻其对全球个人和公共卫生系统影响的重要性。

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