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目的 探讨高龄肺结核临床特征及治疗和管理措施。方法 对高龄肺结核 (Ⅰ组 )从临床特征、治疗及疗效方面与老年肺结核 (Ⅱ组 )进行对比分析。结果 ( 1)Ⅰ组循环系统并发症、营养不良及伴有 3种以上合并症者均高于Ⅱ组 ,合并糖尿病和咯血者少于Ⅱ组 (P <0 .0 5)。 ( 2 )Ⅰ组初治者空洞病变少 ,复治者病变范围广 ,与Ⅱ组比较有统计学意义 (P <0 .0 5)。 ( 3)Ⅰ组痰菌阳性率低于Ⅱ组 (P <0 .0 5)。 ( 4 )Ⅰ组中三药联合化疗与四药联合化疗近期X线好转率无明显差异 (P >0 .0 5) ,四化毒副反应明显高于三化 (P <0 .0 5)。结论 ( 1)对高龄肺结核应提高警惕并加强管理。 ( 2 )治疗高龄肺结核用药要适量 ,三化方案最佳。 ( 3)两组经合理规律治疗均可取得满意效果。
Objective To investigate the clinical features, treatment and management of senile pulmonary tuberculosis. Methods The clinical characteristics, treatment and efficacy of senile pulmonary tuberculosis (group Ⅰ) were compared with senile pulmonary tuberculosis (group Ⅱ). Results (1) Circulatory system complications, malnutrition and more than 3 complications in group Ⅰ were higher than those in group Ⅱ, and those with diabetes and hemoptysis were less than those in group Ⅱ (P <0.05). (2) In group Ⅰ, the number of newly diagnosed pathological lesions was less, and the length of retreat was higher in group Ⅰ than in group Ⅱ (P <0.05). (3) The sputum positive rate of group Ⅰ was lower than that of group Ⅱ (P <0.05). (4) There was no significant difference in the X-ray remission rate between the three drugs combination chemotherapy and the four drugs combined chemotherapy in group Ⅰ (P> 0.05), the toxicity of the four drugs was significantly higher than that of the third chemistry (P0.05) . Conclusions (1) The elderly should be vigilant and strengthen management of tuberculosis. (2) to treat elderly patients with tuberculosis should be appropriate, the best three programs. (3) The two groups can be satisfied with the results of reasonable treatment.