老年与青年结核性胸膜炎临床对比分析

Clinical Comparison of Aged and Young Cases with Tuberculosis Pleurisy

目的探讨老年患者结核性胸膜炎的临床特点。方法本院2003至2004年间共收治结核性胸膜炎443例,老年患者结核性胸膜炎77例,青年患者结核性胸膜炎172例,就两组临床特点实验室检查资料进行对比分析,统计学处理用卡方检验。结果老年患者结核性胸膜炎以气急、胸痛症状较多见,青年患者结核性胸膜炎发热明显,而痰血或咯血、盗汗、消瘦、纳差无明显差异。合并肺结核、慢支肺气肿多见。血液及胸水结核抗体阳性率较青年组高,血性胸水老年患者多见。治疗后胸水吸收时间慢,易出现胸膜增厚,治愈率低于青年组。结论掌握老年患者结核性胸膜炎的临床特点,综合分析,早期诊断。治疗老年患者应尽可能做到个体化用药。

Objective To study the clinical features of tuberculosis pleurisy in aged patients and evaluate the treatment methods. Methods The elderly patients with tuberculosis pleurisy admitted in our hospital from 2003 to 2004 were reviewed and analyzed, the yoccng patients with tuberculosis pleurisy were chosen as control group. Their clinical characteristics were collected. Then x^2 test was used to analyze the data. Results Tuberculosis pleurisy of the elderly man often have the symptoms of breathless and chest pain. It was always accompanied by pulmonary tuberculosis, chronic bronchitis and emphysema while common symptoms of tuberculosis as fever were relatively fewer. There was higher rate in aged patients with tubercular antibody positive. Bloody hydrothorax happened more frequently in elderly patients. After treatment, the elimination of pleural effusion took more time for the elderly than the young and the healing rate in the older was lower. Conclusion It will contribute to early diagnosis if we know more about the clinical features of tuberculosis pleurisy and give a comprehensive analysis. For old patients, once diagnosis, we should try to give personalized medicines.