老年初治肺结核116例临床分析

目的分析老年初治肺结核患者的临床特点，提高诊治水平。方法对116例老年初治肺结核患者临床资料回顾性分析。结果老年初治肺结核患者年龄高发于60～64岁，咳嗽占60．3％，PPD强阳性率为45．7％，痰涂片阳性率为51．7％，痰培养阴性率为56．7％，1个肺野病灶的痰菌阳性与阴性患者为11例、16例，2个，以上肺野病灶的痰菌阳性与阴性患者为49例、40例，肺部出现空洞在痰菌阳性与阴性患者为22例、20例，肺部无空洞在痰菌阳性与阴性患者为38例、36例，完成治疗及治愈者达77．6％。老年初治肺结核患者临床症状不典型，病灶分布与空洞的形成率在菌阳与菌阴的患者中无明显差异性，PPD强阳性率低，不重视痰培养，治愈加完成率低。结论重视老年初治肺结核患者诊治，耐心的宣教，提高老年患者依从性，可提高疗效，控制传染源。

A clinical analysis of initial treatment of tuberculosis for 116 elderly patients

Objective To analyze the clinical characteristics of initial treatment of tuberculosis for elderly patients,and improve the level of diagnosis and treatment. Methods Clinical data of 116 patients who received initial treatment of tuberculosis were analyzed retrospectively. Results The peak age of initial treatment of tuberculosis for elderly patients was 60-64 years.Coughing accounted for 60.3% of the total patients,high positive rate of PPD was 45.7%,positive rate and negative rate of sputum smear were 51.7% and 56.7% respectively.Positive and negative sputum smears were detected in 11 and 16 patients with I lung field lesion,and those were detected in 49 and 40 patients with 2 lung field lesions.Positive and negative sputum smears were detected in 22 and 20 patients with pulmonary cavity,and those were detected in 38 and 36 patients without pulmonary cavity.Completed treatments and cured patients accounted for 77.6% of the total.The clinical symptoms of elderly patients who received the initial treatment of tuberculosis were not typical,and the differences of lesion distribution and rate of cavity formation were not statistically significant in patients with positive and negative sputum smears.High positive rate of PPD was low,the results of sputum smears were not prioritized,and the cure rate and completion rate were low. Conclusion Prioritizing the initial diagnosis and treatment of tuberculosis for elderly patients,educating patiently and improving elderly patients＇compliance all help enhance the curative effect and control the source of infection.