腮腺结核一例并文献复习  

Parotid gland tuberculosis： a case report and literature review

作　　者：王鹏[1] 张忠顺[1] 杨妍[1] 陈岗[2] 肖和平[1] 

机构地区：[1]同济大学附属上海市肺科医院结核病诊疗中心上海市结核病(肺)重点实验室,200433 [2]同济大学附属上海市肺科医院病理科,200433

出　　处：《中国防痨杂志》2014年第7期556-564,共9页Chinese Journal of Antituberculosis

摘　　要：目的 提高对腮腺结核的认识及早期诊断水平。方法 我院2012年经病理组织学明确诊断的1例腮腺结核患者的临床资料，结合国内外2005—2013年文献检索到的34例腮腺结核患者的详细资料，对腮腺结核的临床特点进行回顾性总结分析。 结果 35例腮腺结核患者，男22例，女13例；左侧腮腺结核16例，右侧腮腺结核16例，双侧腮腺结核3例。主要临床特征：腮腺进行性、无痛性肿大（34/35），偶有不规则发热（2/35），偶有龋齿、牙痛、张口困难症状（2/35），盗汗、乏力、消瘦、纳差等结核中毒症状不明显（34/35）；细针穿刺细胞学检查可协助疾病诊断，35例患者中18例进行了细针穿刺细胞学检查，通过细针穿刺细胞学检查确诊者10例（10/18）。35例患者中28例有治疗资料，其中27例进行了规律抗结核药物治疗，疗效好；1例未行抗结核治疗，疗效较差。 结论 对于腮腺结核，药物规律抗结核治疗效果好；临床医师加强对该病的认识和警惕，是早期诊治的关键。Objective To improve the understanding and early diagnostic ability for parotid gland tuberculosis. Methods The clinical characteristics based on the clinical data of a 57-year-old female patient confirmed by pathologic histology in Shanghai Pulmonary Hospital in 2012 and the literature of 34 cases with parotid gland tuberculosis from domestic and “PubMed” database from 2005 to 2013 were retrospectively analyzed. Results Among 35 parotid gland tuberculosis cases. There were 22 males and 13 females. The left and right parotid gland tuberculosis were 16 cases respectively, and the bilateral were 3 cases. The main symptoms were progressive,painless swelling of parotid gland. In additional, fever, dental caries, toothache, difficulty in opening mouth was seldom（2/35） and few patients was suffered from tuberculous symptoms like as night sweat, fatigue, weight loss and anorexia（34/35）. Fine needle aspiration cytology was the great help in diagnosis. There were 18 cases performed by fine needle aspiration cytology and 10 cases with the cytological results. Twenty-seven cases got satisfactory efficacy due to regular treatment and 1 case didn’t due to irregular treatment. Conclusion Parotid gland tuberculosis can get satisfactory efficacy with regular treatment. It should be kept in mind while dealing with parotid swellings patients.

关 键 词：结核 腮腺 药物疗法 治疗结果 

分 类 号：R529.8[医药卫生—内科学]