腹腔脏器结核57例临床分析  

A clinical analysis of 57 cases of abdominal tuberculosis

作　　者：葛瑛[1] 盛瑞媛[1] 邓国华[1] 刘晓清[1] 王爱霞[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院感染内科,100730

出　　处：《中华内科杂志》2005年第12期898-901,共4页Chinese Journal of Internal Medicine

摘　　要：目的探讨腹腔脏器结核的临床特点、诊治方法,以提高对腹腔脏器结核的诊断水平。方法回顾性分析1958年1月-2004年12月间在北京协和医院收治并经病理诊断的57例腹腔脏器结核病例的临床资料。结果肝结核39例,脾结核5例,胰腺结核8例,胃结核3例,肝结核并胃结核1例,肝结核并脾结核1例。男性26例,女性31例,年龄17～68岁。41例(71.9%)患者并存腹腔以外脏器结核或既往有结核病史。主要临床表现有发热(75.4%),结核中毒症状(82.5%),肝脾肿大(57.9%)。多数患者(59.6%)有血沉增快,肝、脾或胰腺占位病变者占64.9%。结论不明原因长期发热伴有肝脾肿大、血沉增快、影像学提示有腹腔脏器占位病变的病例应警惕结核可能,穿刺取活组织病理检查有助诊断,必要时需剖腹探查,及早抗结核治疗预后良好。Objective To explore the clinical characteristics and diagnosis methods of abdominal tuberculosis. Methods The clinical characteristics of abdominal tuberculosis in 57 cases proved by histopathology between 1958 - 2004 were retrospectively analyzed. Results There were 39 cases of tuberculosis of the liver, 5 cases of the spleen, 8 cases of the pancreas, 3 cases of the stomach, 1 case involved both liver and spleen and 1 case involved beth liver and stomach. Twenty-six patients were males and 31 female; with ages ranged from 17 to 68 years （mean 40. 7 years） and most cases （71.9%） having extra-abdominal tuberculosis. Fever （ 75.4% ） , fatigue, anorexia, night sweating, weight loss （ 82. 5% ） and hepatosplenomegaly （57.9%） were the major clinical manifestations. Elevated erythrocyte sedimentation rate （ESR） （59.6%） and abdominal mass （64. 9% ） were found in most of the patients. Conclusions The diagnosis of abdominal tuberculosis should be considered in all patients with fever of unknown origin, especially in those associated with hepatosplenomegaly, increased ESR and abdominal mass. Aspiration biopsy and laparotomy can provide correct diagnosis. The disease can be effectively treated with surgical intervention and antituberculous chemotherapy.

关 键 词：结核 腹腔 临床医学 

分 类 号：R52[医药卫生—内科学]