肺结核并发呼吸衰竭48例临床分析

目的探讨肺结核并发呼吸衰竭的临床特点。方法对48例肺结核并呼吸衰竭进行回顾性分析。结果复治肺结核占66．7％，发病诱因为肺结核活动（66．7％），肺部感染（22．9％），气胸（6．3％），喀血（4．2％）。I型呼衰占62．5％。均有一种或一种以上的并发症，并发多器官功能衰竭（MOF）占29．2％，经常规治疗77．1％（37／48）缓解，18．8％（9／48）死亡，并发MOF者死亡率57．1％。结论肺结核并发呼衰诱因以结核活动及肺部感染多见，并发症多，死亡率高，一旦发生，应积极治疗，以免发展成为MOF。

Clinical analysis of 48 cases of pulmonary tuberculosis complicated with respiratory failure

Objective To investigate the features of pulmonary tuberculosis complicated with respiratory failure. Methods The data of 48 patients with pulmonary tuberculosis complicated with respiratory failure were analyzed retrospectively. Results 66. 7% of all the cases were in retreatment,66. 7% were precipitated by pulmonary tuberculosis activity period,22. 9% with pulmonary infections,6. 3% with pneumothorax,4. 2% with hemoptysis. 62. 5 % belonged to respiratory failure type. All cases had more than one complication, in which 29.2% had multiple organ failure （MOF）. 77. 1% had improvement after routine treatments. 18. 8% died. The mortality rate was 57. 1% in the eases with MOF. Conclusions Pulmonary tuberculosis complicated with respiratory failure is liable to be precipitated by pulmonary tuberculosis activity period and pulmonary infections, with high incidence of complications and mortality. Once it occurs, it should be treated positively, preventing it from developing into MOF.