378例肺结核病人死亡原因分析

The Cause of Death in 378 Patients with Pulmonary Tuberculosis

目的 了解不同年龄组肺结核病人死亡原因及其分布特征。 方法 对 1988年 6月～ 2 0 0 2年 12月肺结核死亡的住院病人 3 78例 ;统计学分析。 结果 死亡病人男女比例 (3 .6:1) ,平均死亡年龄为 64岁 (2 7～ 89岁 ) ;菌阳 117例 ,菌阴 2 3 5例 ;2 79例肺部感染中 18例痰培养阳性 ,大肠埃希菌 7例 ,绿脓杆菌 5例 ,真菌感染 6例。初治 82例 ,复治2 96例 ,直接死于肺结核 3 2 3例 ,肺外结核 2例 (1例结脑 ,1例肠结核 ) ;死于非结核病 5 3例 ,TB -HIV双重感染 1例。 结论 肺结核死亡集中在 5 0岁以上 ,主要死因依次为呼吸衰竭、病变进展、肺心病和咯血 ;肺结核合并呼吸道感染死亡率最高 ,5 0岁以上肺癌合并率较低年龄组明显增多 ,60岁以上病情加重、恶化时不排菌明显高于排菌 ;5

Objective To evaluate the cause of death in different age group of patients with pulmonary tuberculosis (TB) and the distribution feature. Methods Statistic analysis was made to 378 inpatient decedents with pulmonary tuberculosis from June 1988 to Dec. 2002. Result Of the 378 decedents, 297 male and 81 female (3.6:1), mean age 64 years (from 27 to 89). 117 with smear-positive pulmonary tuberculosis (PTB), 235 with smear-negative PTB. 18 cases tested positive to culture examinations among the 279 cases of pulmonary infection, 7 cases infected due to Escherichia coli, 5 cases Bacillus pyocyaneus, 6 cases fungal infection. 82 cases were initial treatment and 296 cases retreatment. 323 decedents were due to TB and 2 decedents due to extra-pulmonary tuberculosis (1 case of tubercular meningitis and 1 case of intestinal tuberculosis), 53 cases died of non-TB and 1 case was TB-HIV. Conclusion The age distribution of TB decedents were concentrated in over 50 years old and the significant causes of death were respiratory failure, pathological deterioration, cor pulmonale and hemoptysis; the mortality rate of TB complicated with infection of the respiratory reached the highest level of all; and the number of complication with lung cancer over 50 years old was much more than that under 50 years old. Cases over 60 years old were with exacerbation and deterioration, the number of non-discharge of bacteria was more that of discharge of bacteria. Of the mortality rate of cases over 50 years old, the number of initial treatment was more than that of retreatment.