老年肺结核的防治

Prevention and Treatment of Senile Pulmonary Tuberculosis

目的探讨老年人肺结核的早期诊断与合理治疗及有效预防。方法通过影像学的动态监测、痰菌培养(结核菌敏感与耐药试验),分析26例老年肺结核病的临床诊治情况,针对其发病特点,找出对策。结果本组65例病人中,男31例、女34例。年龄16～95岁,平均年龄46.6岁。其中:50岁以上老年人26例,70岁以上老年人11例。分别为:95、83、81、79、77、74岁各1例,71岁3例、70岁2例。特点为老年人发病多,复发或再感染者居多,病情重且复杂者居多。结论老年肺结核多为继发性,老年人对结核菌的抵抗力下降,而发病率高是因全身免疫功能下降,肺部免疫力亦随之下降,肺组织弹性减弱,呼吸道分泌功能降低,使肺清除痰液的能力下降,结核菌侵入而发病。其症状不典型,发病隐匿且病程长。老年人耐药病例多、重症病例多,已成为主要慢性传染源。老年人应尽可能避免与肺结核病人接触,以防被传染。

Objective To explore the early diagnosis,treatement and prevention of elderly senile pulmonary tuberculosis.Methods Through the dynamic monitoring by imaging,sputum culture（sensitive and resistant TB test）,to analyzed clinical situation of 26 cases.According to its disease characteristics,to find ways to deal with.Results The 65 patients,male 31 cases,female 34 cases,aged 16 to 95 years old,with an average age of 46.6 years old,26 patients were over 50 years old,11 cases were 70 years old or older.Respectively is： 95,83,81,79,77,74,each in 1 case,71 years 3 cases,70 years in 2 cases.The incidence of the disease is characterized by more than the elderly,the majority of relapse or re-infection,severe illness and the complex are the most.Conclusion Decreased immune function in the elderly body,the lungs also decreased immunity,decreased elasticity of lung tissue,respiratory function,the lungs clear of mucus decreased ability to resist disease.When TB invade the patients,it shows atypical symptoms,occult and longer duration.The elderly shows more resistant cases,more severe cases,and has become a major source of chronic infection.Elderly patients with tuberculosis as much as possible avoid exposure to prevent infection.