老年肺结核180例临床分析

AN ANALYSIS OF 180 CASES OF ELDER PATIEATS WITH PULMONARY TUBERCULOSIS

目的 提高对老年肺结核症的认识。方法 回顾性分析了 180例老年肺结核患者临床资料。结果 老年肺结核病人中复治病例多 (本组资料中达 5 7% ) ,而且合并症多 ,主要以呼吸系统疾病为主 (为 49% )。胸部X线显示病灶呈多样性 ,易误诊、漏诊。结论 临床医师应提高对老年肺结核症的警惕性 ,应慎用肾上腺皮质激素 ,痰找抗酸杆菌及纤维支气管镜检查是正确诊断本病的方法之一。

Objective To investigate elder pulmonary tuberculosis after clinical diagnosis,radiological and laboratary examinations and to facilitate the diagnosis and treatment.Methods The reports of pathological conference on elder pulmonary tuberculosis were collected during the period from 1986 to 1996,180 cases were reviewed.Results The revisit cases of elder pulmonary tuberculosis was 57%.The first visit cases was 43%.This patients were more frequently accompanied by concomitant diseases mainly lung diseas(49%).X ray image was various and to be misdiagnosis and missing diagnosis.Conclusion Physicians should be alert of the occurrence of elder pulmonary tuberculosis especially in immunologically compromised patints.Corticosteriod should be used carefully in patients with desmosis.Fibreoptic bronchoscopy and direct smear examination of sputum are the best methods for the rapid and corret diagnosis.