278例老年人涂阳肺结核X线平片表现(1)
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[摘要] 目的：探讨60岁以上老年人肺结核的影像表现特点，以提高诊断水平。方法：收集278例涂阳肺结核患者的普通胸片影像资料，年龄60～92岁，综合分析其临床及影像学特征。结果：病灶累及双侧肺168例，占60.43%，累及右肺下野161例，占57.91%，累及左肺下野者113例，占40.65%；其中以纤维化病灶为主要表现者169例，占60.79%；有空洞者107例，占38.49%；胸膜改变者156例，占56.12%。结论：老年肺结核在病灶的分布范围、部位上不同于青壮年，其病灶性质以空洞和广泛纤维化为特点，了解其临床及影像表现特征有利于肺结核的早期诊断和治疗。
[关键词] 胸片 肺结核 影像学
[中图分类号] R445.4[文献标识码] B[文章编号] 1673-7210(2011)02(b)-060-02
The chest X-ray findings of 278 cases of smear-positive pulmonary tuberculosis in old age
ZENG Xiangli
(Wolong District Center for Disease Control and Prevention, Nanyang City, He'nan Province, Nanyang 473000, China)
[Abstract] Objective: To detect the imaging characteristics of smear-positive pulmonary tuberculosis in old people in order to improve diagnosis. Methods: 278 patients (age range:60-92) with confirmed pulmonary tuberculosis were analyzed in the clinic and imaging characteristics of radiological photograph. Results: Among 278 patients with pulmonary tuberculosis,the lesions were distributed bilateral lung in 168 cases (60.43%). The lesions were found lower right lung in 161 cases (57.91%). The lesions were found lower left lung in 113 cases (40.65%). Fibrosis as the predominantly was seen in 169 cases (60.79%). The cavity, pleural change were found in 38.49% and 56.12%, respectively. Conclusion: The main imaging characteristics of pulmonary tuberculosis in old age include diffuse fibrosis and cavity. The old age is different from other people in position and distribution range of lesion, which may help clinicians with early diagnosis and management of the Patients with pulmonary tuberculosis.
[Key words] Chest X-ray; Pulmonary Tuberculosis; Imaging
随着全球人口老龄化及全球肺结核回升趋势，老年(60岁以上)肺结核发病率也不断增加，在我国患病年龄高峰上升到了60岁以上的老年组[1]。目前按照我国结核病防治法规，肺结核的治疗和管理必须由结核病防治专业机构统一负责[2]。基层医疗机构由于条件限制，目前其诊断及分类依据主要是依据痰菌检查结果及X线平片表现，本文对2006年2月~2010年11月本中心结核病防治科收治的278例60岁以上老年肺结核涂阳患者临床及X线平片特点进行分析，以探讨老年人肺结核临床及影像学特征，提高其诊断及治疗水平。
1 资料与方法
1.1 一般资料
本组278例患者中，均有完整的临床资料。278例患者中98.56%为初中及小学文化程度的农民；其中男231例、女47例，男女比例为4.91∶1，年龄60~92岁，平均(70.05±6.42)岁，其中60~69岁153例，占55.04%，70~79岁110例，占39.57%，80~89岁13例，占4.68%，90～92岁2例，占0.72%。278例老年患者痰涂片结核杆菌均为阳性 ......
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