老年人肺结核与肺癌并存52例临床分析

摘要

Objective The purpose of the article was to sumarize and investigate the clinical features of coexistence of pulmonary tuberculosis and lung cancer in aged patients. Methods The clinical and laboratory data from 52 eases with coexisted pulmonary tuberculosis and lung cancer during the years between 1981 and 1998 were analyzed. Results Cough,expectoration, feebleness, anorexia, etc. were the predominant symptoms in the patients. Besides, hemoptisis, dyspnea, notable marasmus, listlessness and chest pain were also found. In 12 cases the two nidi located in the same position; in 5 cases round,lumpy or nodulous hyperplasia occurred in the original tubercular focus, an irregular cavern in the thick internal wall of lung, a segmental drowned lung the each original infiltrative focus expanded and complicated with hydrothorax were foufid in 1 case,and an irregular curled shadow displayed beside the original tuberculated focus in 4 cases. Conclusion The coexistence of pulmonary tuberculosis and lung cancer is not an unusual situation. It's important clinical characteristics includes worse general condition, serious symptoms and signs, variable X-ray manifestation,liability in misdiagnosis,intactability and high mortality.%目的：研究老年人肺结核与肺癌并存的临床特点。方法：分析52例两病并存患者的临床和实验室资料。结果：患者除表现为常见的咳嗽、咳痰、乏力、纳差等症状外，还可有咯血、呼吸困难、明显消瘦、精神不振或萎靡、胸痛等表现。两病痛灶在同一部位者12例：在原结核病灶部位显示圆形、块状或结节状增殖性改变者5例；出现内壁不规则厚壁空洞、肺段不张、原浸润性病灶扩大且伴有胸水者各1例；在原结核病灶边缘出现团块状、不规则影者4例。结论：两病并存者并不少见，而患者一般情况差、病情重，肺部x线表现多样，易漏误诊、治疗难、病死率高是其重要临床特点。