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目的:探讨老年涂阳肺结核的临床特点及应用抗结核组合药在治疗老年肺结核时的特点。方法:选取我中心2011年2月到2012年12月收治的137例老年涂阳肺结核病的临床资料进行分析。结果:137例病例中单纯肺结核79例,合并其他疾病58例,合并症依次为糖尿病16例,慢支、肺气肿13例,贫血8例,肺部感染6例,疗程结束治疗痊愈130例,完成疗程4例,死亡2例,不良反应停止治疗1例,共发生药物不良反应57例,其中肝毒性29例,消化道反应24例。结论:老年涂阳肺结核在治疗时容易产生各种不良反应,且老年肺结核患者合并症较多,特别是以糖尿病等慢性病居多,在应用抗结核板式组合药物治疗的同时应重视合并症的控制与治疗,同时在应用组合药物抗结核治疗时应注意个体化差异,灵活合理的调整组合药的用法、用量。
Objective: To investigate the clinical characteristics of elderly smear-positive pulmonary tuberculosis and the characteristics of anti-tuberculosis combination in the treatment of elderly pulmonary tuberculosis. Methods: The clinical data of 137 elderly patients with smear positive pulmonary tuberculosis admitted from February 2011 to December 2012 in our center were selected for analysis. Results: Of the 137 cases, only tuberculosis was found in 79 cases and 58 cases were complicated with other diseases. The complications were as follows: diabetes mellitus (16 cases), chronic bronchitis (13 cases), emphysema (13 cases), anemia (8 cases) and lung infection (6 cases) , Completed the course of treatment in 4 cases, 2 died, 1 case of adverse reactions to stop treatment, a total of 57 cases of adverse drug reactions, including hepatotoxicity in 29 cases, 24 cases of gastrointestinal reactions. Conclusion: Elderly smear-positive pulmonary tuberculosis is prone to produce various kinds of adverse reactions during treatment. Elderly patients with pulmonary tuberculosis have more complications, especially those with chronic diseases such as diabetes. At the same time, they should pay attention to the control of comorbidities while applying anti-tuberculosis combination therapy At the same time, we should pay attention to the individual differences in the application of anti-TB combination therapy, and adjust the usage and dosage of the combination medicine flexibly and reasonably.