老年患者肺结核合并肺癌临床及CT分析.pdfVIP

老年医学与保健2013年第 l9卷第3期GeriatrHealthCare，2013，Vo1．19．No．3 老年患者肺结核合并肺癌临床及 CT分析 从建华 朱惠莉 范志强 摘【要】目的 分析老年患者肺结核合并肺癌的临床特征与CT影像学特点，提高肺结核合并肺癌的诊断率。方法 对经病理证实的45例肺结核合并肺癌老年患者的临床表现、实验室检查及CT影像进行分析，并与同期单纯肺癌48 例、单纯肺结核23例进行对照分析。结果肺结核合并肺癌组胸痛、呼吸困难少于单纯肺癌组，乏力、盗汗多于单纯 肺癌组；肺结核合并肺癌组发热、咯血少于单纯肺结核组 ，刺激性咳嗽、持续性胸痛和血性胸水多于单纯肺结核组 (P0．05oCT上肺结核合并肺癌组卫星灶、钙化影多于单纯肺癌组；团块影伴分叶、短毛刺 、小泡征多于单纯肺结 核组 (PO．01o结论在老年肺结核患者随访时，应警惕并发肺癌的可能，需结合病史及影像学表现综合分析。 关【键词】肺结核；肺癌；诊断 【中图分类号】R524；R734．2 文【献标识码】A 文【章编号】1008—8296(2013)-03—183-03 DOI：10．3969U．issn．1008—8296．2013—03—18 AnalysistheclinicalcharacteristicsandCTfilmsofpulmonarytuberculosiscomplicatinglungcancerinagedpati- entsCONGJian-hua．ZHUHui—tt．FANZhi-qiang．DepartmentofPulmonaryMedicine．HuadongHospital，Fudan University, Shanghai200040, China Correspondingauthor：ZHUHui—li，E—mail：zhuhuili001@126．corn lAbstract】0bjectiveToanalyzetheclinicalandCTmanifestationsofpulmonarytuberculosiscomplicatinglungcancer inordertoimproveitsdiagnosticrate．M ethodsTheclinicaldataandCT imagingfeaturesof45agedpatientssuffering frompulmonarytuberculosiscomplicatinglungcancer，whichwereconfirmedwithpathology，wereanalyzedandcompared． ResultsThedyspnea， chestpainwerelessthansimplelungcancergroup， andthefatigue，nightsweatweremorethan thoseofthesimplelungcancergroup．Thefever， emptysiswaslessthansimpletuberculosis， whiletheirritativecough， durativechestpainandpluraleffusionweremorethanthesimplelungcancergroup P(0．05)．Intheimagingfeatures． thereweremoresatellitelesionsandcalcificationthanthoseofthesimplecancergroup，andthemasseswithlobed， short burrandbubbleweremorethanthetuberculosisgroup 0．01)．ConclusionsCliniciansshouldkeepinmindoftheOC— currenceoflungcancerduringthefollow-upofpatientswithtuberculosis． Itisimportanttoanalyzethemedicalhistory， clinicaldataandCTimagingcomprehensively． K【eywordslPulmonarytuberc