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目的:探讨高龄患者炎性胸腔积液的临床特征及治疗方法。方法:回顾性分析15例年龄大于75岁炎性胸腔积液患者的临床资料。结果:15例患者中男12例,女3例;年龄77~91岁,中位年龄84.7岁。住院日最短19d,最长42d,平均29.7d。经治疗后,患者咳嗽、发热、胸闷、胸痛等症状在2~3周改善,住院3周复查见11例(11/15)胸水吸收,其中7例完全吸收,胸闷气短症状改善。胸腔积液最短2周吸收,最长持续存在9周,多数在2~3周有明显变化;平均4周可完全吸收。经随访18月以上未见恶性疾病依据。结论:高龄患者炎性胸腔积液临床症状体征不典型;以中少量胸腔积液为多见,病程长,部分患者长期存在胸水。调节免疫治疗及均衡营养支持等方法对于积液的吸收有促进作用。全身的脏器功能衰退尤其是胸膜功能衰退可能是发病机制之一。
Objective: To investigate the clinical features and treatment of inflammatory pleural effusion in elderly patients. Methods: The clinical data of 15 patients with inflammatory pleural effusion older than 75 years were retrospectively analyzed. Results: Among the 15 patients, there were 12 males and 3 females, ranging in age from 77 to 91 years with a median age of 84.7 years. Shortest hospitalization 19d, the longest 42d, an average of 29.7d. After treatment, the symptoms of cough, fever, chest tightness, chest pain and other symptoms improved in 2 to 3 weeks, 11 cases (11/15) of pleural effusion were found in 3 weeks of hospitalization, of which 7 cases were completely absorbed and the symptoms of chest tightness and shortness of breath were improved. Pleural effusion 2 weeks minimum absorption, the longest sustained 9 weeks, most of 2 to 3 weeks have significant changes; an average of 4 weeks can be completely absorbed. After follow-up of 18 months or more no basis for malignant disease. Conclusion: The clinical symptoms and signs of inflammatory pleural effusion in elderly patients are not typical; in a small amount of pleural effusion is more common, longer duration, some patients with long-term pleural effusion. Regulating immunotherapy and balanced nutrition support and other methods for the absorption of effusion have a catalytic role. Systemic organ dysfunction, especially pleural failure may be one of the pathogenesis.