국내 한 민간종합병원에서 결핵 환자의 진단 및 치료 실태 = Clinical Characteristics, Diagnosis, Treatment, and Clinical Outcomes of TB Patients at a Private University Hospital in Korea

다국어 초록 (Multilingual Abstract)

Clinical Characteristics, Diagnosis, Treatment, and Clinical Outcomes of TB Patients at a Private University Hospital in Korea

국문 초록 (Abstract)

연구배경: 결핵은 아직도 우리나라에서 보건학적으로 중요한 문제임에도 불구하고 공공의료부문과 달리 민간의료부문에서의 결핵 환자 진료 실태는 잘 알려져 있지 않은 상황이다. 국내 민간병원에서의 결핵환자 진료 실태를 파악하고자 본 연구를 시행하였다.
방법: 2001년에서 2002년 사이에 등록된 15세 이상의 결핵 환자 912명을 대상으로 후향적으로 의무기록을 분석하였다. 환자를 폐결핵과 폐외결핵, 초치료군과 재치료군으로 나누어 임상상, 진단방법, 약제감수성 검사 결과, 치료처방, 약제부작용 및 치료결과를 분석하였다.
결과 : 912명의 평균 나이는 49.2세, 남녀비는 56：44%였다. 폐결핵 초치료 및 재치료, 폐외결핵 초치료 및 재치료 환자는 각각 449, 169, 237, 57명이었고, 274명(30.0%)에서 기저질환이 동반되었다. 893명(97.9%)에서 세균학적 검사가 시행되었고 배양 양성은 폐결핵에서 337명(54.5%), 폐외결핵에서 87명(29.6%)이었다(P＜0.05). 도말 양성 폐결핵은 40.8% (252/618)였다. 결핵균 PCR은 폐결핵의 18.3%, 폐외결핵의 63.6%에서 시행되었으며 양성률은 전체 환자 중 각각 5.0%와 34.0%였다(P＜0.05). 다제내성결핵은 7.6% (21/278)에서 확인되었다. 전체 환자의 치료완료율은 74.6%였고, 배양 양성 폐결핵 환자에서의 완치율 및 치료완료율은 각각 54.9%와 16.3%였다. 전체 환자의 치료중단율은 13.7%, 사망률은 0.5%였다.
결론: 서울 소재 한 민간대학병원에서의 결핵의 진단 및 치료는 국내 결핵관리지침에 부합할 뿐만 아니라 새로운 진단기법의 도입 등 만족할 만하였으나 중도 탈락 환자를 관리하지 못하는 단점이 확인되었다. 추후 중도 탈락 환자를 관리할 수 있는 방법의 개발이 필요하다.

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