老年人肺脓肿12例临床病理分析  

A retrospective clinicopathological study of lung abscess in the elderly

作　　者：孙铁英[1] 陈曼丽[2] 马正中[3] 

机构地区：[1]卫生部北京医院呼吸科 [2]卫生部北京医院内科 [3]卫生部北京医院病理科

出　　处：《中华老年医学杂志》2004年第8期537-539,共3页Chinese Journal of Geriatrics

摘　　要：目的　探讨老年人肺脓肿临床病理特点和误诊的原因。　方法　对我院尸检发现的老年人肺脓肿 12例进行临床与病理特点的对照分析。男 11例 ,女 1例 ;年龄 6 0～ 88岁。　结果　 12例生前均未诊断出肺脓肿。每例均患有冠心病、心肌梗死、高血压、脑血管病、慢性阻塞性肺疾病、糖尿病、肿瘤等多种基础疾病中的 2种或 2种以上疾病。临床表现及X线胸片表现不典型。痰培养显示多数病例有 2种或 2种以上病原菌 ,主要为克雷伯氏杆菌、绿脓杆菌、白色念珠菌。尸检结果 :单个肺脓肿 3例 ,多发性肺脓肿 9例。　结论　老年人肺脓肿临床表现不典型是误诊和漏诊的主要原因。Objective To explore the causes of misdiagnosis of lung abscess and its clinical pathological characters. Methods The clinical data of autopsy-proven lung abscess in Beijing Hospital from 1980 to 1995 were reviewed. Results Twelve patients consisted of 11 males and 1 female. Their age ranged from 60 to 88 years. None of them was clinically diagnosed lung abscess before death. Concomitant dieases were severe and complex, mostly coronary disease, hypertension, COPD, cerebrovascular disease and diabetes mellitus. The clinical presentation and chest X-ray of lung abscess in the elderly were deceptively nonspecific and variable. Over 2 types of pathogens were isolated from sputum culture, mostly klebsiella pneumoniae, pseudomonas aeruginosa, candida. The autopsy showed 3 cases with a isolated lung abscess and 9 cases with lung multi-abscess. Conclusions The reasons for misdiagnosis of lung abscess in the elderly might be the variability of clinical presentation, the other concomitant disease. Frequent pursuit of chest CT scan in suspected cases is guarranted .

关 键 词：老年人 肺脓肿 病理学 病原菌 肺组织 

分 类 号：R563.2[医药卫生—呼吸系统]