老年肺结核的临床特征

The Clinical Features Senile Pulmonary Tuberculosis

目的回顾性分析400例老年肺结核患者临床资料,总结老年肺结核临床特征,提高其临床诊断和治疗水平。方法对汕头市第三人民医院2005年1月-2008年1月收治的400例老年肺结核的临床资料进行回顾性分析总结。结果老年肺结核疫情呈上升趋势,临床症状、胸部X线表现不典型,病情重,排菌率高,结核菌素试验多为阴性,并发症多。各级综合医院医师,应熟悉肺结核的早期非特异性症状,对具有肺部疾患出现原因不明的发热、咳嗽、咯血、食欲减退、呼吸困难为主要症状者应高度警惕肺结核存在的可能性,正确运用辅助检查,重视X线胸片、痰菌检查手段,做到早期发现,及时遵照"早期、联合、规律、全程、适量"规范的抗结核治疗原则,对患者实施治疗。结论老年肺结核病情重,排菌率高,各级医生应提高对老年肺结核的认识,减少漏诊率和误诊率,规范有效地管治传染源,服务于我国的结核病控制工作。

Objective To investigate the clinical features of aged pulmonary tuberculosis, and to improve the clinical diagnosis and treatment of this disease. Methods The clinical data of 400 elderly patients tuberculosis treated in our hospital from January 2005 to January 2008 were retrospectively analyzed and summarized. Results The epidemic of elderly tuberculosis was in up- ward trend, clinical symptoms and chest X-ray findings were atypical, illness was severe, bacteria was high, most of the tuberculin test was negative, more complications existed. Conclusion General Hospital physicians at all levels, should be familiar with the early non-specific symptoms of tuberculosis. The lung disease of unexplained fever, cough, hemoptysis, loss of appetite, difficulty in breathing as the main symptoms of tuberculosis should be highly alerted to the possibility of the existence of the disease. Correct use of laboratory examinations, X-ray emphasis on sputum examination methods, early detection of patients in a timely manner in accordance with ＂early,joint, regular,full, adequate,＂ the standard anti-TB treatment guidelines were important.