老年肺结核合并糖尿病临床剖析.docVIP

老年肺结核合并糖尿病临床剖析 　　[摘要] 目的 探讨老年肺结核合并糖尿病的临床特点及诊治经验，便于控制好糖尿病，利于肺结核病情控制，改善患者症状，加快病灶吸收，空洞闭合，避免因传染性而危害社会，乃至肺结核复发，影响患者生活质量。 方法 总结我院60岁以上老年肺结核合并糖尿病的临床特点，血糖控制水平与肺结核症状改善、病灶变化之间的联系等。 结果 老年肺结核合并糖尿病症状不典型，痰菌阳性率高，空洞发生率高，干酪病灶较多、较重，传染性强，社会危害性较大，误诊率高，早期不易确诊，空洞闭合难，治愈率低，抗痨药物不良反应较多，不易坚持、完成抗痨治疗疗程，容易复发等特点。 结论 应加强60岁以上老年肺结核合并糖尿病患者的早期发现，早期规范抗痨治疗、管理，加强抗痨药物不良反应的监测和及时处理，保证血糖控制良好，避免空洞长期不能闭合，其内结核菌休眠，导致复发、甚至耐药肺结核的发生，这些对结核病防治工作起到良好的促进作用。 　　[关键词] 肺结核；老年；糖尿病；临床特点 　　[中图分类号] R521；R587.1 [文献标识码] B [文章编号] 2095-0616（2014）16-191-03 　　Clinical analysis of senile pulmonary tuberculosis complicated with diabetes mellitus 　　JIANG Xiuhui ZHANG Xinge ZHANG Quanhai YANG Yuqian 　　Department of Cadre Two Ward， the Sixth Peoples Hospital of Nanyang City， Nanyang 473000， China 　　[Abstract] Objective To investigate the clinical features and treatment experience of tuberculosis in elderly with diabetes， to control diabetes well easily， which will help control tuberculosis disease， improve symptoms and accelerate foci， cavity closure， to avoid infectious and harm to society， and even tuberculosis relapse， affecting the quality of life of patients. Methods We summarized the clinical characteristics of pulmonary tuberculosis who aged over 60 with diabetes， blood glucose control level and tuberculosis symptom improvement， the connection between the lesion changes. Results The symptoms of senile pulmonary tuberculosis with diabetes are atypical， and the pathogenic bacteria have high positive rate. The caseous leseous lesions are more severe and progressive and have a much higher percentage of cavitations. The senile pulmonary tuberculosis with diabetes has strong infection， high misdiagnosis and low cure rate and so on. Conclusion The management of patients suffering from senile pulmonary tuberculosis with diabetes who are over 60 years old should be strengthened and the therapy should be standardized， which has a positive effect for preventing TB. 　　[Key words] Tuberculosis； Senile； Diabetes； Clinical characterist