520例老年病人咯血病因研究

目的：分析老年人咯血的常见病因及其次序特点，以期及早作出正确诊断。方法：根据临床特点、细胞学、细菌学、结核菌素试验、Ｘ线胸片、纤维支气管镜、肺ＣＴ、肺ＭＲＩ、痰结核菌ＰＣＲ及其他有关检查确定诊断。结果：由肺结核引起者居首位（２９．４％），肺癌居第２位（２２．７％），慢性支气管炎居第３位（１６．２％）。咯血的量、出现的时间及反复性与病因有一定关系。结论：肺结核、肺癌、慢性支气管炎是引起老年人咯血的３个主要原因。对持续性痰中带血或新近出现的难以控制的痰中带血或小量咯血，首先要想到肺癌的可能。

Etiological Research of Hemoptysis in 520 Aged Patients

Objective:To analyze the common etiological causes and sequencial characteristics of hemoptysis in the aged patients in order to make a correct diagnosis as early as possible.Method:The diagnosis was made according to clinical manifestation,cytology,bacteriology,OT,chest X-ray film,bronchoscopy,lung CT,MRI,sputum tuberculin PCR and the other related examinations.Results:Pulmonary tuberculois was found to be the first etiological cause (29.4%),lung cancer (22.7%) and chronic bronchitis (16.2%) to be the second and third,respectively.The amount of hemoptysis,time of its appearance and symptom relapse were closely related to the etiology.Conclusion:Pulmonary tuberculosis,lung cancer,and chronic bronchitis are the main causes of hemoptysis in the aged patients.The lung cancer should be considered firstly in those newly appeared,hard to be controlled sputum with blood and small amount of hemoplysis.