目的 探讨影响结核性渗出性胸膜炎发生胸膜肥厚的因素.方法 对2000年1月-2007年12月收治的72例结核性渗出性胸膜炎患者发生胸膜增厚的因素进行分析.结果 胸膜肥厚的发生率与年龄、就诊时间、胸水蛋白含量、血浆白蛋白含量、胸水中细胞教及是否抽液有关.结论 高龄患者比较容易发生胸膜增厚;就诊晚的患者胸膜增厚的发生率高;胸水蛋白含量高易发生胸膜增厚;血浆白蛋白水平低下胸膜增厚的发生率显著增高;积极的胸穿抽液可避免胸膜增厚的发生.

Objective:To investigate the clinical characteristics of pulmonary tuberculosis complicated with diabetes and the effect of controlling diabetes on the therapeutic effect of tuberculosis chemotherapy.Methods:The clinical date in 51 patients with infiltrative pulmonary tuberculosis complicated with diabetes from January 2001 to December 2006 treated in our hospital were analysed,and compared with those in 569 cases of simple pulmonary tuberculosis as control group.Results:Compared with the simple pulmonary tuberculosis patients,the patients with infiltrative pulmonary tuberculosis complicated with diabetes were more serious,more caseous foci,more pulmonary cava,more bacilli in sputum and more recurrent cases.The therapeutic effect of the patients with infiltrative pulmonary tuberculosis complicated with diabetes was similar to those with simple pulmonary tuberculosis in the sputum bacillus disappearance rate and the tuberculosis focus absorption,if the diabetes was stable and the blood glucose was less than 8.4 mmol/L.Conclusion:Diabetes may impede the recovery of tuberculosis,so controlling the blood glucose is important to the treatment and prognosis of pulmonary tuberculosis complicated with diabetes.

目的:探讨老年人重症肺炎的临床特征与预后。方法:分析我院住院治疗的56例老年重症肺炎的临床资料。结果:56例中行气管插管机械通气达48.2%,白细胞升高仅占37.5%,而中性粒细胞升高占73.2%,低钠血症41.1%,低钾血症28.6%,痰培养以革兰阴性杆菌检出率为53.6%,死亡率67.9%。结论:老年重症肺炎临床特征不典型;白细胞升高较少,中性粒细胞多升高,易并发电解质絮乱,痰培养以革兰阴性杆菌检出率高,预后与并发基础疾病有关。