老年慢性阻塞性肺疾病合并肺结核感染的临床观察

发布时间：2018-10-17 08:54

【摘要】：目的研究老年慢性阻塞性肺疾病合并肺结核感染的临床表现,指导临床诊断和治疗老年慢性阻塞性肺疾病合并肺结核感染的临床观察。方法回顾性分析2012年1月-2013年10月在医院进行诊治的老年慢性阻塞性肺疾病合并肺结核感染的患者92例,48例患者具备典型的肺结核症状的老年慢性阻塞性肺疾病患者视为治疗组,对于初治患者采用2RHZE/4HR方案,对于复治患者采用3DLVE/6DLE治疗方案;44例不具备典型肺结核症状的老年慢性阻塞性肺疾病患者,按一般的慢性阻塞性肺疾病进行治疗为对照组,对比两组患者临床指标,数据采用SPSS13.0进行统计分析。结果经过15~30d的治疗后,治疗组患者中双肺斑片状阴影消失的34例占70.8%,44例对照组患者中双肺斑片状阴影消失的患者12例占29.2%,经检验治疗组患者双肺斑片状阴影消失的比例明显高于对照组,差异有统计学意义(P0.05%);48例治疗组患者中空洞闭合或缩小的患者13例占27.1%,44例对照组患者中空洞闭合或缩小的患者26例占59.1%,经检验治疗组患者空洞闭合或缩小的比例明显低于对照组,差异有统计学意义(P0.05%)。结论应加强对老年慢性阻塞性肺疾病合并肺结核感染的临床诊断,对于确诊的患者,临床医护人员应根据老年患者自身的情况,制定相应的化疗方案,选择不良反应小的抗结核药物对老年慢性阻塞性肺疾病合并肺结核的患者进行长期的治疗。
[Abstract]:Objective to study the clinical manifestations of chronic obstructive pulmonary disease (COPD) complicated with pulmonary tuberculosis (COPD) infection in the elderly and to guide the clinical diagnosis and treatment of chronic obstructive pulmonary disease (COPD) with pulmonary tuberculosis infection in the elderly. Methods from January 2012 to October 2013, 92 elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis and 48 patients with typical pulmonary tuberculosis symptoms were analyzed retrospectively. The patient is treated as a treatment group, 2RHZE/4HR regimen was used for initial treatment and 3DLVE/6DLE regimen was used for retreated patients. 44 elderly patients with chronic obstructive pulmonary disease who did not have typical pulmonary tuberculosis symptoms were treated as control group according to general chronic obstructive pulmonary disease. The clinical indexes of the two groups were compared and the data were analyzed by SPSS13.0. Results after 15 days of treatment, In the treatment group, 34 cases (70.8%) of the patients with bilateral pulmonary plaque shadow disappeared, 12 cases (29.2%) of the 44 cases of the control group, and the proportion of the patients in the treatment group was significantly higher than that in the control group. The difference was statistically significant (P0.05%), there were 13 cases of cavity closed or narrowed in 48 cases of treatment group, 26 cases of 26 cases of cavity closing or narrowing of 44 cases of control group, and the proportion of cavity closing or narrowing of patients in the treatment group was significantly lower than that in the control group, the proportion of cavity closing or narrowing in the treatment group was significantly lower than that in the control group. The difference was statistically significant (P 0.05%). Conclusion the clinical diagnosis of elderly patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis should be strengthened. Select antituberculous drugs with small adverse reactions for long-term treatment of elderly patients with COPD complicated with pulmonary tuberculosis.
【作者单位】：临沂市人民医院东医疗区内科;齐齐哈尔医学院附属第三医院呼吸内科;
【基金】：山东省科技厅研究基金资助项目(212-DX-04861)
【分类号】：R563.9;R521

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