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目前,肺结核病的发病率以老年组最高。然而临床上对这个问题的注意不够,以至常造成误诊或延误诊断。现报告5例并讨论如下。病例报告例1 患者,男,59岁,病案号:46400。患者1958年曾发现左侧肺结核,口服异烟肼治疗3个月。1985年春发现糖尿病,9月出现声嘶,胸片示左上肺斑片状阴影,住某医院行纤维支气管镜等项检查,疑诊肺癌。治疗一段时间不见好转,对诊断产生怀疑,经几家医院会诊又改诊为慢性肺脓疡。曾使用先锋霉素等多种抗生素治疗无效,因大咯血入院。入院后咳嗽,间断咯血痰。体查:一般情况尚好,血象正常,血糖230毫克%,痰浓缩找到抗酸杆菌,胸片示左上肺斑片状阴影,密度不均。经INH、利福平(RFP)、乙胺丁醇(EB)、吡嗪酰胺(PZA)抗痨和控制糖尿
At present, the incidence of tuberculosis is highest in the elderly group. However, the clinical attention to this issue is not enough, often resulting in misdiagnosis or delay in diagnosis. Now report 5 cases and discuss as follows. Case report 1 patient, male, 59 years old, medical record number: 46400. Patients in 1958 have been found in the left pulmonary tuberculosis, oral isoniazid treatment for 3 months. The spring of 1985 found that diabetes, hoarseness in September, chest X-ray film shows the shadow of the upper left lung, a hospital line of fiberoptic bronchoscopy and other items, suspected lung cancer. Treatment for a period of time did not improve, the diagnosis of doubt, after several hospital consultations and diagnosis of chronic lung abscess. Have used cephalosporins and other antibiotics ineffective treatment, due to a large hemoptysis hospitalization. Cough after admission, intermittent hemoptysis sputum. Physical examination: the general situation is good, normal blood, blood sugar 230 mg%, sputum concentration to find acid-fast bacilli, chest X-ray film shows the top left shadow, uneven density. After INH, rifampicin (RFP), ethambutol (EB), pyrazinamide (PZA) anti-tuberculosis and control of diabetes