260例老年肺结核的临床分析.docVIP

精品论文 参考文献 260例老年肺结核的临床分析 何春喜 杨旭 　　（云南省昆明市第三人民医院结核病院结核内科 650301） 　　【摘要】目的 提高老年肺结核临床特点的认识及诊疗水平,制定合理有效的预防措施。方法 选取我院2009年-2012年收治的60岁以上的肺结核患者260例(老年组),同时选取我院同期收治的18-59岁的肺结核患者260例(中青年组),将两组肺结核患者的临床资料进行回顾性对照分析。结果 老年肺结核咳嗽、咯痰、胸闷气促、乏力纳差症状多见，而发热、盗汗、咯血症状少见；空洞型肺结核多见，而胸膜炎及血播型肺结核少见；血清结核抗体阳性率及痰结核菌涂片/培养阳性率低；合并症以COPD、肺心病、高血压、糖尿病多见，而肺外结核少见。Plt;0.01具有显著统计学意义。结论 老年肺结核临床症状不典型，血清结核抗体检测阳性率低，痰结核菌涂片/培养阳性率低, 合并症多，易引起漏诊、误诊,临床应高度重视。 　　【关键词】 肺结核 老年患者 临床分析 　　【中图分类号】R563 【文献标识码】A 【文章编号】2095-1752（2014）06-0077-02 　　 　　Clinical analysis of 260 cases of elderly patients with pulmonary tuberculosis 　　HE Chun xi, YANG Xu 　　【Abstract】 Objective To improve the understanding of clinical feature and treatment effect of elderly patients with pulmonary tuberculosis. Methods 260 cases of elderly patients older than age 60 with pulmonary tuberculosis in our hospital during 2009 to 2012 were chosen as Group Old, and another 260 cases of pulmonary tuberculosis patients at age 18 to 59 were chosen as Group Young. A retrospective analysis was conducted between the two groups. Results Coughing, stethocatharsis, dyspnea and anorexia were more frequent in Group Old, whereas pyrexia, night sweating and hemoptysis were more frequent in Group Young. Cavernous pulmonary tuberculosis was more frequent, however pleurisy and acute miliary pulmonary tuberculosis were less frequent in Group Old. The positive rate of tubercle bacillus in the sputum and tubercle bacillus specific antibody in serum were both lower in Group Old. In terms of complication, COPD, cor pulmonale, hypertension and diabetes were more frequent in Group Old, while extrapulmonary tuberculosis and silicosis were less frequent. Conclusion The clinical presentations of elderly patients with pulmonary tuberculosis are atypical. So, more attention should be paid to elderly patients during clinical diagnosis. 　　【Key words】 pulmonary tuberculosis elderly patients clinical analysis 　　近年来,结核病的发