恶性肿瘤放化疗致免疫受损合并肺结核的发生情况.docVIP

精品论文 参考文献 恶性肿瘤放化疗致免疫受损合并肺结核的发生情况 黄洪林永州市中心医院北院肿瘤科 湖南永州 425000 　　【摘 要】目的：探讨恶性肿瘤放化疗致免疫受损合并肺结核的发生情况、临床表现、诊断及治疗效果。方法：回顾性分析我院自2011 年12 月～2012 年12 月收治的50 例合并肺结核的恶性肿瘤患者的临床资料，对其发病情况、临床表现、诊断和抗结核治疗的转归进行总结分析。结果：50 例恶性肿瘤合并肺结核患者在我院同期诊断出的恶性肿瘤患者中占1.8%，占同期诊断出的肺结核患者的12.8%。 　　14 例（28%）患者在恶性肿瘤化疗过程诊断出肺结核，26 例（52%）患者在恶性肿瘤放疗过程中诊断出，10 例（20%）在同时放化疗过程中诊断出。经抗结核治疗4～6 个月后X 线或CT 检查病灶明显吸收稳定，治疗有效人数为41 例，占82%。9 例结核菌阳性患者6 个月后均转阴，6 个月后纤维空洞型肺结核患者的空洞均缩小为原来的1/3，其中1 例（2%）患者空洞完全闭合。治疗6 个月后患者无出现任何明显的不良反应。结论：恶性肿瘤患者放化疗后免疫受损，合并肺结核的发病率较高，临床症状无明显特异性，主要表现为消瘦乏力、发热，最常见受累部位为肺部，一线抗结核药治疗效果显著。 　　【关键词】恶性肿瘤；放化疗；肺结核；发病率[Abstract] Objective ：To investigate immunocompromised cancer chemotherapy-induced pulmonary tuberculosis incidence ， clinicalmanifestations，diagnosis and treatment.Methods：A retrospective analysis of our hospital from 50 patients with malignant pulmonary tuberculosis inDecember 2011 - December 2012 admitted to the clinical data were analyzed its incidence，clinical presentation，diagnosis and TB treatmentoutcomes.Results：50 cases of malignant pulmonary tuberculosis patients in our hospital diagnosed cancer patients over the same period accounted for1.8%，12.8% over the same period diagnosed tuberculosis patients.14 cases（28%）patients diagnosed with tuberculosis，cancer chemotherapy，26patients（52%）of patients diagnosed with malignant tumors during radiotherapy in 10 patients（20%）in the course of radiotherapy and chemotherapysimultaneously diagnosed.After anti-tuberculosis treatment for 4 to 6 months after the X-ray or CT lesions was absorbed stable，the number ofeffective treatment in 41 cases，accounting for 82%.Six months after the 9 cases of TB-positive patients were negative，six months after fibrocavitaryempty tuberculosis patients were reduced to the original 1/3，1 patient（2%）patients empty completely closed.Patients without any significant adversereactions after 6 months of treatment.Conclusion：The cancer after chemotherapy immunocompromised patients，the incidence of pulmonarytuberculosis is high，no specif