老年初治肺结核合并2型糖尿病患者的临床诊治分析

发布时间：2018-04-24 07:22

本文选题：肺结核 + 型糖尿病　；参考：《中国老年学杂志》2017年21期

【摘要】：目的分析老年初治肺结核合并2型糖尿病患者的临床诊治分析。方法选取老年初治肺结核合并2型糖尿病患者62例为观察组,另选取同期55例单纯老年初治肺结核患者为对照组,对症治疗后观察两组临床疗效(包括胸部病变范围、临床症状、痰菌检查结果、空洞变化等)。结果老年初治肺结核结合2型糖尿病患者病灶范围更广,X线检查肺野多为2个及以上,发热、咯血、空洞情况更为普遍,达88.7%、59.7%、41.2%;单纯性肺结核X线检查肺野多为1个,发热、咯血、空洞情况分别为65.5%、38.1%、16.4%;研究组治疗90d后痰菌检查(-)患者为35.5%,空洞闭合率26.9%,不良反应率27.4%,30.6%患者病灶范围缩小;对照组治疗后临床情况优于研究组,痰菌检查(-)患者为70.1%,空洞闭合率77.8%,不良反应9.1%,58.2%患者病灶范围缩小;研究组治疗总有效率64.5%,22例无效均系血糖控制不佳;对照组总有效率89.1%,6例无效患者中,5例有药物不良反应(P0.05)。结论老年初治肺结核合并2型糖尿病患者治疗有效率低,药物不良反应率高,空洞不易闭合,预后恢复差,临床治疗应降糖和抗结核并重。
[Abstract]:Objective to analyze the clinical diagnosis and treatment of pulmonary tuberculosis with type 2 diabetes mellitus. Methods Sixty-two cases of pulmonary tuberculosis complicated with type 2 diabetes mellitus at the beginning of the year were selected as the observation group and 55 cases as the control group. The clinical effects of the two groups (including the range of chest lesion) were observed after symptomatic treatment. Clinical symptoms, sputum bacteria examination results, cavity changes and so on. Results at the beginning of the year, the foci of pulmonary tuberculosis combined with type 2 diabetes mellitus were more than 2 or more, fever, hemoptysis and cavity were more common, up to 88.7% 59.7% and 41.2%, X-ray examination of simple pulmonary tuberculosis was mostly 1, fever was more common. The hemoptysis and cavity were 65.5% and 38.1%, respectively; in the study group, the number of patients with sputum bacteria examination 90 days after treatment was 35.55.The cavity closure rate was 26.9%, and the adverse reaction rate was 27.4% (30.6%), and the clinical situation in the control group was better than that in the study group. The total effective rate of sputum bacteria examination was 70.1%, the cavity closure rate was 77.8%, the adverse reaction was 9.1% and 58.2%, the total effective rate of the study group was 64.5%, the total effective rate of 22 cases was poor blood glucose control, the total effective rate of the control group was 89.1% and the total effective rate of the control group was 89. 1% of the 6 ineffective patients, 5 cases had the adverse drug reaction (P0.05). Conclusion the treatment of pulmonary tuberculosis with type 2 diabetes at the beginning of the year is of low effective rate, high rate of adverse drug reactions, difficult closure of cavity and poor prognosis. Both hypoglycemic and antituberculous treatment should be paid more attention to in the treatment of pulmonary tuberculosis at the beginning of the year.
【作者单位】：青海省第四人民医院中西医科;青海省第四人民医院药剂科;
【分类号】：R521;R587.1

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