结核性大叶性肺炎的临床研究

目的　分析结核性大叶性肺炎的临床特点。方法　对本院2 0 0 2年3月至2 0 0 4年3月所收治的1 5例结核性大叶性肺炎的临床特点进行综合分析。结果　①起病急骤,②全身症状明显,病灶变化快,部位不典型,咳嗽、咳痰,肺实变体征及肺部湿罗音,似大叶性肺炎。③白细胞正常,或减少:胸片及CT片有大片或肺叶分布的渗出性病变。④痰菌阳性率高。⑤多种抗生素治疗无效,抗痨治疗后效果显著。结论　随着不典型肺结核的不断增加,早期诊断和及时治疗至关重要。强化抗结核治疗能获得满意疗效。

Clinical research on tuberculosis lobar pneumonia

Objective To analyze the clinical characteristics of the tuberculosis lobar pneumonia. Methods. A comprehensive analysis of the clinical characteristics of 15 cases was conducted. Results (1) The onset of the disease was fast. (2) The disease showed systemic symptoms, which changed quickly. The affected lesions were TB non-typical including fever, cough, expectoration, etc. The symptoms were similar to lobar pneumonia. (3) Lab results: most patients showed normal values of the count of peripheral white blood cells (WBC). Few showed a decrease of the WBC count. X-ray film and CT of the lungs showed similar in lobar pneumonia. (4) The rates of acid-fast staining by sputum smear and bronchoscopic brushing smears were most positive. (5) The effect of using anti-virus drugs was low, however. The anti-tuberculosis drugs were effective. Conclusion It is important to identify symptoms in order to make early diagnosis and on-time treatment. With anti-tuberculosis therapy strengthened, the treatment effects can be satisfactory.