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1、老年结核性胸膜炎临床及胸腔镜下表现分析作者：罗国仕，杜春玲，刘玉全,刘先军，熊畅单位：442000湖北省十堰市，那阳医学院附属太和医院呼吸科【摘要】目的总结老年结核性胸膜炎临床特点和胸腔镜下衣现特征，提高胸腔镜检杏对老年结核性胸膜炎诊断价值的认识。方法冋顾性分析41例通过内科可弯曲胸腔镜检查和组织活检确诊的老年结核性胸膜炎临床资料和胸腔镜下表现特征。结果老年结核性胸膜炎临床表现不典型，以咳嗽(75.6%)和胸闷、气促(87.8%)出现比例垠高，并存病多(85.4%),谋诊率高(68.3%)。镜下表现小点状结节41.5%，单发、多发
2、结节26.8%,胸膜充血、水肿19.5%,胸膜肥厚、粘连12.2%,病变部位分布于后胸堆壁层胸膜46.3%,前胸壁壁层胸膜12.2%,侧胸樂壁层胸膜7.3%,膈胸膜7.3%,弥漫型19.5%,脏层胸膜7.3%,无1例发生严重并发症。结论老年结核性胸膜炎临床衣现缺乏特异性，应尽早行内科胸腔镜检查明确诊断。【关键词】胸膜炎；结核；老年人；胸腔镜Analysisonclinicalfeaturesandmanifestationsunderthoracoscopyinelderlypatientswithtubercularpleuri
3、syLUOGuoshi,DUChunling,LIUYuquan,LIUXianjun,XIONGChang,WEINa,TUMingli.DeparmentofRespiratoryDisease,TaiheHospitalAffiliatedtoYunyangMedicalCollege,Shiyan442000,China【Abstract]ObjectiveTosummarizetheclinicalfeaturesandmanifestationsunderthoracoscopyof41elderlypatientsw
4、ithtubercularpleurisy,andtodiscusstheimportanceofmedicalthoracoscopyforthediagnosisoftubercularpleurisyintheelderly.MethodsTheclinicalfeaturesandmanifestationsunderthoracoscopyof41patientswithtubercularpleurisyintheelderlydiagnosedbyflexibleelectronassistedthoracoscop
5、yandbiopsywereretrospectivelyanalyzed・ResultsTheclinicalpresentationsoftubercularpleurisywereatypicalintheelderly.Cough(75.6%)andchesttightnessanddyspnea(87.8%)werethemostcommon,andthecoexistenceproportionofbothdisease(85.4%)andmisdiagnosisrate(68.3%)werehigh.Basedono
6、bservationofthoracoscopythereweresmallpunctualsarcoidosis(41.5%),oneormoresarcoidosis(26.8%),pleuralcongestionandedema(19.5%)andpleuralthickeningandfibrinousadhesion(12.2%)in41elderlypatients.Distributionofthefocuslesionwasasfollows:46.3%onparietalpleurawithposterior,
7、12.2%onanterior,7.3%onlateral,7.3%ondiaphragmaticpleura,19.5%ditTusivelydistributedand7.3%onvisceralpleura・Therewasnoseriouscomplication.ConclusionsTheclinicalprofilesoftubercularpleurisyarenonspecificintheelderly.Tomakeadefinitediagnosis,medicalthoracoscopicsurgerysh
8、ouldbeearnedoutasearlyaspossible・【Keywords]pleurisy;tuberculosis;aged;thoracoscopy随看老年人口增多，老年结核性胸膜炎发病率亦逐渐増加[1]。但山于老年人在生理和病理上
