口腔结核11例临床病理分析  

Clinical and pathological analysis of oral tuberculosis in 11 consecutive cases

作　　者：琚梧桐[1] 刘莹[1] 谈亦然 尹雪莱[1] 董敏俊[2] 王丽珍[3] 李江[3] 钟来平[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院,口腔颌面-头颈肿瘤科,上海200011 [2]上海交通大学医学院附属第九人民医院·口腔医学院,放射科,上海200011 [3]上海交通大学医学院附属第九人民医院·口腔医学院,口腔病理科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2017年第6期543-547,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨口腔结核的临床表现、诊治方案和预后。方法:回顾分析本科2012年11月—2016年6月收治的11例口腔结核患者的临床、病理及预后情况,包括性别、年龄、症状、辅助检查、治疗方案、病理检查和随访结果等。结果:11例患者中,男6例,女5例;年龄48~78岁,平均年龄59.1岁。5例表现为口腔黏膜溃疡(牙龈4例、颊部1例),5例为口腔肿物(牙龈1例、颊部3例、唇部1例),1例为颌骨骨髓炎;仅1例伴有颈部淋巴结肿大。辅助检查中,5例患者胸片检查提示伴有陈旧性结核灶。11例患者的治疗方案中,2例行切取活检后药物治疗,1例行切取活检后观察,8例行切除活检手术治疗。病理诊断为结核后,6例患者接受结核菌素试验(PPD)检查,其中4例为阳性,并且接受抗结核药物治疗。随访8~48个月,平均24.9个月,1例失访。随访期间,口腔病灶均无复发及新病灶形成。结论:口腔结核比较少见,临床上无特异性表现,确诊有赖于病理及相关辅助检查,治疗方案以手术或手术联合药物治疗为主,疗效较好。PURPOSE： To analyze oral tuberculosis in terms of clinical appearance, clinical differential diagnosis, treatment and prognosis. METHODS： From November 2012 to June 2016, eleven patients with oral tuberculosis were treated. The patients＇ general condition, clinical symptoms and signs, imaging modalities, pathological files, treatment and prognosis were collected and analyzed. RESULTS： Among 11 patients, there were 6 males and 5 females with a mean age of 59.1 years, ranging from 48 to 78 years old. Five patients presented ulceration （four in gingiva and one in buecal region）, four patients presented mass （one in gingival and three in buccal region）, one patient presented osteomyelitis; only one patient presented enlargement of cervical lymph nodes. Five patients＂ chest radiography showed sequelae of pulmonary tuberculosis. Two of ten patients received drug therapy after surgical biopsy, and eight patients received surgical resection of mass in the oral cavity. After being diagnosed as oral tuberculosis by pathological examination, six patients received purified protein derivative examination, and four of them received drug therapy against tuberculosis. The mean follow-up period was 24.9 months ranging from 8 to 48 months, with one patient loss to follow-up, no lesion recurrence was found during the follow-up period. CONCLUSIONS： Oral tuberculosis is rare, with no specific clinical appearance. Pathology and other examinations are necessary for diagnosis of oral tuberculosis. The treatment of oral tuberculosis is suggested as surgical resection or surgical resection combined with drug therapy against tuberculosis. The prognosis of oral tuberculosis is fine.

关 键 词：口腔结核 诊断 治疗 预后 

分 类 号：R529.8[医药卫生—内科学]