结核性胸膜炎治疗中发生胸膜结核瘤32例的临床分析  

Clinical analysis of 32 cases of pleural tuberculoma during the treatment of tuberculous pleurisy

作　　者：孔伟利[1] 白大鹏[1] KONG Weili;BAI Dapeng(Department of Tuberculosis,Tianjin Haihe Hospital,Tianjin 300350,China)

机构地区：[1]天津市海河医院结核科,天津300350

出　　处：《重庆医学》2020年第14期2348-2350,共3页Chongqing medicine

基　　金：天津市卫生计生委科技基金项目(2015KZ045)。

摘　　要：目的分析结核性胸膜炎治疗过程中发生胸膜结核瘤的临床及影像特征,为胸膜结核瘤的诊治提供参考。方法回顾性分析2016年1月至2018年12月该院收治的32例结核性胸膜炎治疗过程中出现胸膜结核瘤的患者资料,所有患者均行连续胸部CT影像学观察,分析患者临床表现、影像学特征、演变及治疗转归。结果32例患者中男15例,女17例;年龄15~47岁,平均23.4岁;其中胸膜结核瘤发生在右侧22例。胸膜结核瘤出现时间为2~5个月,平均2.7个月,其中29例给予抗结核药物治疗后临床症状好转,病灶逐渐吸收,疗程结束后11例仍留有小结节病灶,3例因合并胸壁结核而在治疗4~6个月时行手术。结论胸膜结核瘤更多发生在部分年轻人结核性胸膜炎治疗中,多发生在治疗2~3个月,以右侧多见,螺旋CT可更早发现胸膜结核瘤,大部分患者可经内科治疗痊愈。Objective To analyze the clinical and imaging characteristics of pleural tuberculoma during the treatment of tuberculous pleurisy,and provide references for the diagnosis and treatment of pleural tuberculoma.Methods The data of 32 patients with tuberculous pleurisy complicated with pleural tuberculoma who were admitted to this hospital from January 2016 to December 2018 were analysed.All patients underwent continuous chest CT scans for imaging observation,and the clinical manifestations,imaging characteristics,evolution and treatment outcomes were analysed.Results Among the 32 patients,there were 15 male and 17 female pleural tuberculoma cases,aged from 15 to 47 years old,and the average age was 23.4 years old.Among the,22 cases of pleural tuberculoma occurred on the right side.The appearance time of pleural tuberculoma was 2 to 5 months,with an average of 2.7 months.Among them,29 cases were treated with anti-tuberculosis drugs.Then,the clinical symptoms were relieved,and the lesions gradually were absorbed.At the end of the treatment,11 cases still had small nodules,and 3 cases received surgery at 4 to 6 months of treatment due to combination with chest wall tuberculosis.Conclusion The pleural tuberculoma occurs more frequently in the treatment of tuberculous pleurisy in some young people.It mostly occurs within 2 to 3 months of treatment.It is more common on the right side.Spiral CT can detect the pleural tuberculoma earlier.Most patients with pleural tuberculoma could be cured by medical treatment.

关 键 词：胸膜 结核 胸膜炎 诊断 临床特征 治疗结果 

分 类 号：R521.7[医药卫生—内科学]