CAJ | 학술논문

目的：探讨老年社区获得性肺炎(CAP)的临床及影像学特点与治疗转归。方法150例老年人社区获得性肺炎住院患者的临床及影像学资料,对其进行回顾性分析。结果150例中合并有心、脑血管及慢性阻塞性肺疾病(COPD)等基础疾病者114例(76.0%),具有发热及白细胞升高分别为53例(35.3%)及39例(26.0%)；有呼吸道症状者125例(83.3%)。影像学检查胸片检查132例,漏诊34例(25.8%)；CT检查89例,100%阳性发现；107例(71.3%)表现为沿支气管分布小斑片状模糊阴影呈小叶性肺炎改变；98例(65.3%)为两侧肺炎。治疗病程平均37.4 d,5例因并发症死亡。结论老年社区获得性肺炎患者较多合并有基础疾病；临床表现不典型,病情较重；影像学检查胸部平片有漏诊存在, CT是重要的补充检查,多为小叶性肺炎,两肺发病多见；该病治疗疗程较长,部分病例预后不良,应该引起重视。
목적：탐토노년사구획득성폐염(CAP)적림상급영상학특점여치료전귀。방법150례노년인사구획득성폐염주원환자적림상급영상학자료,대기진행회고성분석。결과150례중합병유심、뇌혈관급만성조새성폐질병(COPD)등기출질병자114례(76.0%),구유발열급백세포승고분별위53례(35.3%)급39례(26.0%)；유호흡도증상자125례(83.3%)。영상학검사흉편검사132례,루진34례(25.8%)；CT검사89례,100%양성발현；107례(71.3%)표현위연지기관분포소반편상모호음영정소협성폐염개변；98례(65.3%)위량측폐염。치료병정평균37.4 d,5례인병발증사망。결론노년사구획득성폐염환자교다합병유기출질병；림상표현불전형,병정교중；영상학검사흉부평편유루진존재, CT시중요적보충검사,다위소협성폐염,량폐발병다견；해병치료료정교장,부분병례예후불량,응해인기중시。
Objective To explore the clinical and imaging data of elderly community-acquired pneumonia(CAP).MethodsSelected 150 cases of elderly patients with community acquired pneumonia, and retrospectively analyzed their clinical and imaging data.ResultsOut of all 150 cases, 114 cases(76.0%) accompanied by basic diseases, including cerebrovascular diseases, cardiovascular diseases and chronic obstructive pulmonary disease; 53 cases(35.3%) with fever; 39 cases(26.0%) with elevated white blood cells; 125 cases(83.3%) with respiratory symptoms; 34 cases(25.8%) with chest X-ray radiography out of 132 cases had no finding, nevertheless, all 89 cases (100%) with CT scan had positive finding. 107 cases (71.3%) out of all 150 cases with lobular pneumonia, the radiological feature is more areas of consolidation with small ill-defined shadow distributing along the bronchi; 98 cases(65.3%) with bilateral pneumonia. The average duration of the disease were 37.4 days, 5 cases of death due to complications.ConclusionThe elderly community acquired pneumonia has atypical clinical features, accompanied mostly by many basis diseases. It is easy to be miss diagnosed with only a chest X-ray examination, while CT is very good for evaluating this disease. Most of the elderly community acquired pneumonia is lobular pneumonia and bilateral pneumonia. The average duration of the disease is long with poor prognosis, it should be taken seriously.