689例住院老年结核的临床研究

目的通过对老年肺结核患者的临床症状、胸片表现、痰检及PPD皮试等、治疗进行分析,探讨老年肺结核的发病特点。方法对2000~2004年临床收治的60岁及以上的689例老年肺结核患者的临床资料进行分析。结果①临床症状不典型:除69例患者无任何表现,体检时被发现诊断为肺结核外,多以咳嗽(78.2%)、咳痰(59.5%)、胸闷、气喘(49.1%)、咯血(38.6%)等呼吸道表现为症状。结核中毒症状除发热(48.2%)外,而盗汗、乏力等症状不甚明显。②合并症多:伴有一种或多种合并症的为576人,占86.3%。③病程迁延漫长,最长35年。④涂阳率高,占47.0%。⑤不正规抗痨治疗者多。结论全社会要加强对老年肺结核的研究,增强对老年肺结核特点的认识,提高其早期诊断和防治效果。

The clinical study of 689 elder inpatients of pulmonary tuberculosis

Objective To examine elder pulmonary tuberculosis in-patients through their symptoms, the manifestations on X-ray films, sputum examination, PPD test, complications and effects of the treatment.Methods The study included the information for the in-patients over 60 years old and who were admitted between Jan.2001 and Apr.2004 (n=689).Results (1) Atypical symptoms. Except some cases (n=69) who were diagnosed with pulmonary tuberculosis by physical examination, all others had typical clinical symptoms. There were 620 cases (89.98%) had various symptoms, including respiratory symptoms as cough (78.2%), expectoration (59.52%), breathless (49.1%) and hemoptysis (38.6%). However, the tuberculous intoxity symptoms as fatigue, night sweat were rare, except fever (48.2%). (2) Complications were very common. There were 576 cases (86.3%) complicated one or more diseases as COPD, diabetes mellitus etc. (3) The disease course was very long, most having 35 years. (4) The sputum smear positive rate was high (57.1%). (5) The irregular therapy was common.Conclusion It must be stressed that it is important to study elder pulmonary tuberculosis and to increase the awareness of elder tuberculosis as a specialty and improve the effects of early diagnosis and therapy.