慢性阻塞性肺疾病急性加重期合并肺结核76例临床分析.docVIP

慢性阻塞性肺疾病急性加重期合并肺结核76例临床分析 目的对慢性阻塞件肺疾病急性加重期 (AECOPD)合并肺结核的临床特点进行回顾性分析， 探讨其早期诊断及治疗措施。方法收集我院2011年1 月?2013年12月呼吸内科及感染科76例AECOPD合 并肺结核的住院患者临床资料并进行回顾性分析。结 果AECOPD合并肺结核患者中老年患者多见 (73.7%),男性多于女性，患者的临床表现不典型，发 热，盗汗等结核中毒症状发生率低，临床易漏诊、误 诊，晨痰及支气管肺泡灌洗液涂片抗酸染色阳性率高 (55.3%)o经过个体化治疗后，70例患者症状好转出 院继续门诊抗结核治疗，6例治疗无效死亡。结论随 着COPD患者的逐年增多，COPD合并肺结核的患者 也在逐渐增多，因此临床上需引起高度重视。对COPD 患者出现原因不明发热及治疗效果不佳者应加强肺结 核的筛查,以早期诊断，早治疗，提高治愈率。 核的筛查, 以早期诊断，早治疗，提高治愈率。 关键词慢性阻塞性肺疾病；肺结核；诊断；治 疗 Clinical Analysis of 68 Cases of Acute Exacerbation of COPD Patients Complicated with Pulmonary Tuberculosis TANG Bing-song,YANG Xiang-yong (Department of Respiratory, Yongzhou City Central Hospital, Yongzhou 425100,Hunan ,China) Abstract ObjectiveTo retrospectively analyze the clinical features of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary tuberculosis(PTB),and to explore the early diagnosis and treatment. MethodsCollected 76 cases of AECOPD complicated with PTB hospitalized patients* clinical data were retrospectively analyzed in our hospital of Respiratory Medicine and Infectious Diseases Department, from January 2011 to December 2013.Results AECOPD patients with pulmonary tuberculosis is more common in older patients (55.3%) ,more men than women, the clinical manifestations were atypical, a low incidence of fever, night sweats and other symptoms of tuberculosis poisoning,, high omission diagnostic rate and mistake diagnostic rate, morning sputum and bronchoalveolar lavage fluid smear acid-fast staining is high positive rate (55.3% ). After individualized treatment, 70 patients symptoms improved were discharged to continue anti-TB treatment, 6 patients ineffective treatment were died.Conclusion With increasing year by year in patients with COPD, COPD patients with pulmonary tuberculosis is gradually increased, the clinical doctor should pay high attention to the problems. COPD patients for reasons unknown fever and poor treatment of patients , should be strengthened tuberculos