老年性肺结核临床特点分析

目的探讨老年肺结核的临床特征及治疗方法。方法随机抽取我院2010年1月至2013年6月249例60岁以上老年肺结核，对其临床资料进行回顾性分析。结果老年肺结核复治病例为75．5％，菌阳病例为47．4％，培阳耐药病例为33．7％，空洞病例为73．5％；本组病例经6个月标准化疗收到了较好疗效，胸部平片所见：病灶吸收为77．5％，空洞变化：闭合或缩小为85．2％，痰菌阴转为88．1％。结论老年肺结核病情复杂、病程长；老年人因年老体弱、细胞免疫功能低下，易感染结核病或事先有潜伏的结核病灶重新活动，病灶范围广泛多易形成空洞，菌阳性率高，合并症及并发症多，易误诊。需详细询问病史，重视痰结核菌的检查，摄胸部平片及（或）肺CT，以便及时诊断，给予合理化疗方案治疗，是可以取得较好的疗效。

Clinical characteristics of senile pulmonary tuberculosis

Objective To investigate the clinical characteristics of senile pulmonary tuberculosis and treatment. Methods Randomly selected hospital from January 2010 to June 2013 249 cases of tuberculosis aged 60 or older,the clinical data were retrospectively analyzed. Results Senile tuberculosis retreatment cases was 75.5%,47.4% cases of smear positive,culture-positive resistant cases was 33.7% ,73.5% cases voids; this group of patients after six months with standard chemotherapy received a good effect, the chest radiograph findings： foci was 77.5 %, voids change： closed or reduced to 85.20%,88.1% sputum conversion. Conclusion Senile tuberculosis disease complex, longer duration; elderly due to frail elderly ,immune dysfunction, susceptibility had latent tuberculosis or tuberculosis prior to re-active, more easy to form a wide range of lesion cavity, bacteria positive rate, complications and complications, often misdiagnosed. Require detailed history, attention to sputum examination, a chest radiograph and（or）lung CT,so that when the diagnosis of acute,given reasonable chemotherapy,it could get better results.