老年非典型肺结核76例临床诊治分析  

Clinical analysis of 76 senior patients with atypical tuberculosis

作　　者：关虹[1] 胡连峰[1] 

机构地区：[1]辽宁省鞍山市千山医院,辽宁鞍山114012

出　　处：《中国冶金工业医学杂志》2013年第3期257-259,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的探讨老年非典型肺结核的诊治方法。方法对2008年3月至2010年12月我院收治的76例老年非典型肺结核患者的临床资料进行回顾性分析。结果 (1)首次就诊明确诊断27例(占35.5%)、可疑诊断28例(占36.8%)、在外院误诊为其他疾病21例(占27.6%),可疑和误诊患者经影像学检查确诊9例、经纤维支气管镜病理检查确诊33例、手术病理检查确诊3例、抗结核治疗有效证实4例。(2)初治患者应用2RHEZ/4RH方案治疗、复治患者应用2SRHEZ/6RH方案治疗,随访1～4年、平均2.5年,治愈44例(占57.9%)、好转29例(占38.1%)、死亡3例(占3.9%)。结论老年非典型肺结核临床表现不典型、影像学征象复杂,容易造成误诊或漏诊,临床医生应努力提高诊断和治疗水平,减少误诊或漏诊。Objective To discuss the diagnosis and treatment methods in senior patients with atypical tuberculosis.Methods The retrospective analysis of 76 senior patients with atypical tuberculosis in hospital from March,2008 to December 2012.Results（1）At the first visit,27 cases were diagnosed as atypical tuberculosis（35.5%）;28 cases were suspected as atypical tuberculosis（36.8%）;21 patients were misdiagnosed as other diseases in other hospitals（27.6%）.Among the suspected and misdiagnosed cases,9 of them were finally diagnosed as atypical tuberculosis by medical imaging examination,33 by fiberoptic bronchoscopy pathological examination,3 by surgical pathological examination,and 4 by effective anti-tuberculosis treatment.（2）The initial treatment was the 2RHEZ/4RH schema,while the continued treatment was the 2SRHEZ/6RH schema.The time of follow-up visits ranged from 1 year to 4 years,with an average of 2.5 years.44 of the 76 patients were cured（57.9%）,29 reported improvement（38.1%）,and 3 died（3.9%）.Conclusion The clinical manifestations of atypical tuberculosis are not typical,the imaging features are complicated,and thus misdiagnosis and missed diagnosis occur easily.The clinicians should try their best to improve level of diagnosis and treatment for atypical tuberculosis and avoid misdiagnosis and missed diagnosis.

关 键 词：非典型 肺结核 老年 诊断 治疗 

分 类 号：R521[医药卫生—内科学]