16例脾结核临床分析  

Clinical Analysis on 16 Cases with Splenic Tuberculosis

作　　者：黄焕军[1] 刘瑶[1] 林菊生[1] 刘南植[1] 田德安[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,武汉430030

出　　处：《临床消化病杂志》2008年第5期300-302,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨脾结核的诊断和治疗措施。方法对16例脾结核患者的临床资料进行回顾性分析。结果16例病人中表现为发热、盗汗、腹胀、腹痛和脾肿大分别为11例次(68.8%)、6例次(37.5%)、8例次(50%)、10例次(62.5%)和13例次(81.2%)。腹部B超及CT检查10例有脾内占位性病变,3例脾内有钙化灶,另3例为脾弥漫性肿大。手术及病理诊断脾结核9例,3例因脾内有钙化灶诊断脾结核,另4例诊断性抗结核治疗有效而诊断脾结核。16例病人中有8例合并脾外结核。所有病人都经过半年以上的抗结核治疗,经随访预后良好。结论脾结核诊断主要依据脾病理学检查及诊断性治疗,系统性抗结核治疗及选择性手术治疗是脾结核的主要有效治疗手段。Objective To summarize the clinical features,diagnosis and treatment of splenic tuberculosis. Methods The clinical data of 16 cases with splenic tuberculosis were retrospectively analyzed. Results Among 16 patients, fever was found in 11, night sweat in 6, abdominal distension in 8, abdominal pain in 10, splenomegaly in 13. Abdominal CT and ultrasonic examinations revealed focal splenic space occupying lesions in 10 cases, focal calcifications in 3, and splenomegaly in 3 cases. 9 cases of splenic tuberculosis were determined by surgery ,3 cases by local spleen calcifications, and 4 cases by diagnostic therapy. Among the 16 patients,8 cases had extrasplenic tuberculosis. All the patients received anti-tuberculosis chemotherapy for more than half a year,and recovered well. Conclusion The diagnosis of splenic tuberculosis is mainly referring to pathology and diagnostic therapy. Systemic anti-tuberculous therapy and selectivity surgical treatment are the main therapenutic method.

关 键 词：脾结核 诊断 治疗 

分 类 号：R525[医药卫生—内科学]