摘要
目的 通过对老年肺结核患者的临床症状、诊断、治疗进行分析 ,探讨老年肺结核的发病特点。方法 对 1 998～ 2 0 0 2年临床收治的 6 0岁及以上的 348例老年肺结核患者的临床资料进行分析。结果 ①临床症状不典型 ,除 1 8例患者无任何表现 ,体检时被发现诊断为肺结核外 ,多以咳嗽 (77 3% ) ,咳痰 (5 6 4 % ) ,发热(4 3 0 % ) ,咯血 (30 6 % )等呼吸道表现为症状 ,而盗汗 ,乏力 ,纳差等结核中毒症状不甚明显。②合并症多 ,伴有一种或多种合并症的为 2 4 2人 ,占 6 9 5 %。③病程迁延漫长 ,最长 30余年。复治患者比例高 ,占 5 2 3% ,慢性纤维空洞型肺结核相对较多 ,占 39 1 % ,易成为慢性排菌者。④涂阳患病率高 ,占 6 8 1 %。高于我国肺结核涂阳患病率 6 1 6 % [3 ] 。⑤胸片及结核菌素试验 (PPD)等辅助检查不特异 ,如PPD多呈一般阳性或阴性 ,强阳性仅占 1 9 3%。⑥不正规抗痨治疗者多 ,治愈率低 ,为 5 4 3% ,远低于世界卫生组织提出的传染性肺结核治愈率达85 %的全球结核病的控制目标[4] 。结论 全社会要重视老年结核病 ,加强对老年肺结核的研究 ,增强对老年肺结核特点的认识 。
Objective To discuss the characters of elder patients with tuberculosis,through the analysis on clinical symptoms,diagnosis,and treatment of elder patients. Methods Retrospectively analysized clinical data of 348 cases elder patients with tuberculosis aged over 60 years during 1998～2002. Results ①The clinical symptoms are atypical,respiratory symptoms such as cough(77.3%),expectoration (56.4%),fever(43.0%),coughing up blood(30.6%)are the main clinical manifestation.Of which 18 cases with no clinical symptoms are diagnosed as tuberculosis when they had heath-examinations.②The complications are more,242 cases have one or more complications (69.5%).③The disease course is long,the longest is 30 years,the cases of chronic fibro cavernous pulmonary tuberculosis(39.1%) are relatively more than that of any other types,the ratio of retreatment cases are high(52.3%).④The morbidity of smear-positive cases(68.1%) is higher than that of average smear-positive cases in china(61.6%) [3] .⑤Supplementary examinations such as chest films and PPD are not unique.PPD is general positive or negative and intense positive cases are only 19.3%.⑥Many cases are not treated regularly,the cure rate of tuberculosis(54.3%) is far lower than that of WHO's Controlling aim(85%) [4] .Conclusion The whole society should pay more attention to elder patients with tuberculosis,improve the investigation,acknowledge,early diagnosis and treatment of elder patients with tuberculosis.
出处
《医药论坛杂志》
2004年第8期1-2,5,共3页
Journal of Medical Forum
关键词
老年
肺结核
发病特点
诊断
治疗
Pulmonary tuberculosis
Agedness
Clinic
Prevention and cure
