摘要
目的对慢性阻塞性肺疾病急性加重期(AECOPD)合并肺结核的临床特点进行回顾性分析,探讨其早期诊断及治疗措施。方法收集我院2011年1月~2013年12月呼吸内科及感染科76例AECOPD合并肺结核的住院患者临床资料并进行回顾性分析。结果 AECOPD合并肺结核患者中老年患者多见(73.7豫),男性多于女性,患者的临床表现不典型,发热,盗汗等结核中毒症状发生率低,临床易漏诊、误诊,晨痰及支气管肺泡灌洗液涂片抗酸染色阳性率高(55.3豫)。经过个体化治疗后,70例患者症状好转出院继续门诊抗结核治疗,6例治疗无效死亡。结论随着COPD患者的逐年增多,COPD合并肺结核的患者也在逐渐增多,因此临床上需引起高度重视。对COPD患者出现原因不明发热及治疗效果不佳者应加强肺结核的筛查,以早期诊断,早治疗,提高治愈率。
Objective To retrospectively analyze the clinical features of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary tuberculosis(PTB),and to explore the early diagnosis and treatment.Methods Col ected 76 cases of AECOPD complicated with PTB hospitalized patients'clinical data were retrospectively analyzed in our hospital of Respiratory Medicine and Infectious Diseases Department,from January 2011 to December 2013.Results AECOPD patients with pulmonary tuberculosis is more common in older patients(55.3%),more men than women,the clinical manifestations were atypical,a low incidence of fever,night sweats and other symptoms of tuberculosis poisoning,high omission diagnostic rate and mistake diagnostic rate,morning sputum and bronchoalveolar lavage fluid smear acid-fast staining is high positive rate(55.3%).After individualized treatment,70 patients symptoms improved were discharged to continue anti-TB treatment,6 patients ineffective treatment were died.Conclusion With increasing year by year in patients with COPD,COPD patients with pulmonary tuberculosis is gradual y increased,the clinical doctor should pay high at ention to the problems.COPD patients for reasons unknown fever and poor treatment of patients,should be strengthened tuberculosis screening,it is very important to take early stage diagnosis and treatment for those patients,to improve the cure rate.
作者
唐炳松
杨湘永
TANG Bing-song;YANG Xiang-yong(Department of Respiratory,Yongzhou City Central Hospital,Yongzhou 425100,Hunan,China)
关键词
慢性阻塞性肺疾病
肺结核
诊断
治疗
Chronic obstructive pulmonary discase
Pulmonary tuberculosis
Diagnosis
Treatment
