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目的:探讨老年喉结核的临床特征,旨在对老年喉结核患者的早期发现及早期治疗。方法:对13例老年喉结核患者均行纤维喉镜、胸部X线摄片、病理检查及抗结核治疗,13例中,采用2HRZ/4HR方案5例,2HRZ/7HR方案8例。局部治疗:异烟肼(INH)0.1g溶入生理盐水20ml中雾化吸入。药物剂量可根据患者的耐受性适当调整,耐受性较好者可用常规剂量。用药期间注意动态监测肝功能及相关并发症的治疗,并定期复查喉部。结果:老年喉结核以声嘶为主要症状,病变部位多位于声带、室带,84.6%(11/13)伴有肺结核,53.8%(7/13)误诊为喉恶性肿瘤;7例经系统抗结核治疗,临床治愈,随访1～2年无复发;1例临床症状明显得到控制;2例未能坚持治疗;3例失访。结论:老年喉结核临床表现不典型,应引起临床医生重视,对疑有喉结核的老年患者应及时行活体组织病理检查。
Objective: To investigate the clinical features of elderly patients with laryngeal tuberculosis, aimed at early detection and early treatment of laryngeal tuberculosis in the elderly. Methods Thirteen elderly patients with laryngeal tuberculosis underwent laryngoscopy, chest radiography, pathological examination and antituberculous therapy. Of the 13 patients, 5 were treated with 2HRZ / 4HR and 8 with 2HRZ / 7HR. Local treatment: Isoniazid (INH) 0.1g dissolved in saline 20ml inhalation. The dosage of the medicine can be adjusted according to the tolerance of the patient, and the conventional dosage can be used for the better tolerance. Pay attention during the medication dynamic monitoring of liver function and related complications of treatment, and regular review of the throat. Results: Elderly laryngeal tuberculosis was the main symptom of hoarseness. Most of the lesions were located in the vocal cords and ventricles, 84.6% (11/13) had pulmonary tuberculosis, and 53.8% (7/13) misdiagnosed as laryngeal malignancies. Seven patients Tuberculosis treatment, clinical cure, follow-up 1 to 2 years without recurrence; 1 case of clinical symptoms were significantly controlled; 2 cases failed to adhere to treatment; 3 cases were lost. Conclusion: The clinical manifestations of laryngeal tuberculosis in the elderly are not typical, should pay attention to the clinician, elderly patients suspected of laryngeal tuberculosis should be timely living tissue biopsy.