睾丸结核33例临床特征  

Clinical characteristics of testicular tuberculosis:analysis of 33 cases

作　　者：肖科 钟利 赵东霞 罗瑜 曹汴川 XIAO Ke;ZHONG Li;ZHAO Dongxia;LUO Yu;CAO Bianchuan(Department of Infectious Diseases,Department of Tuberculosis,Infection and Immunity Laboratory,the Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院感染病科,结核病科,感染与免疫实验室,四川泸州646000

出　　处：《中国感染与化疗杂志》2022年第1期30-33,共4页Chinese Journal of Infection and Chemotherapy

基　　金：四川省卫生健康委员会课题基金(20PJ139);四川省重点学科(传染病学)建设项目基金(SZD0421)。

摘　　要：目的了解睾丸结核的临床表现、诊断方法、治疗及预后,减少误诊及漏诊。方法收集2014年1月—2019年6月西南医科大学附属医院收治的睾丸结核病例,统计分析患者的临床资料。结果33例男性患者,年龄16~78岁,中位年龄45岁,27例无基础疾病,4例合并糖尿病,1例合并慢性肾衰竭,1例合并尘肺。临床表现以睾丸/阴囊局部症状为主(32/33,97.0%),单侧睾丸受累31例,双侧睾丸受累2例,其他部位合并的结核主要为附睾28例(84.8%)、肺15例(45.5%)、肾脏13例(39.4%)。辅助检查以睾丸彩超/CT、组织病理学/细胞学、结核分枝杆菌相关检查为主。所有患者均接受抗结核治疗,11例行病变睾丸切除术,10例行病灶清创术。治疗后31例治愈,1例好转,1例抗结核治疗中死于基础疾病。结论睾丸结核多见于青中年男性,临床症状不典型,影像学联合病理学及结核分枝杆菌相关检查是诊断睾丸结核的主要方法,正规抗结核治疗联合适当的手术治疗是有效的治疗方法,预后多数较好。Objective To understand the clinical manifestations,diagnostic methods,treatment,and outcomes of testicular tuberculosis,so as to reduce misdiagnosis and missed diagnosis.Methods The clinical data of testicular tuberculosis patients admitted to the Affiliated Hospital of Southwest Medical University from January 2014 to June 2019 were collected and analyzed.Results A total of 33 male patients[16-78(median 45)years of age]were included in this analysis.No underlying disease was found in 27 cases.Diabetes mellitus was identified in 4 cases,chronic renal failure,and pneumoconiosis in one case each.The main clinical manifestations were local symptoms of testis/scrotum(32/33,97.0%),specifically,unilateral testis in 31 cases,bilateral testis in 2 cases.Tuberculosis was also found in epididymis(28/33,84.8%),lung(15/33,45.5%),and kidney(13/33,39.4%).Testicular color Doppler ultrasound/CT,histopathology/cytology,and related examinations of Mycobacterium tuberculosis were the main methods to confirm the diagnosis.All patients received anti-tuberculosis treatment.Overall,11 patients had their diseased testicles removed.Ten patients underwent lesion debridement.Finally,31 patients were cured after treatment,one improved,and one died of underlying disease during anti-tuberculosis treatment.Conclusions Testicular tuberculosis is more common in young and middle-aged men with atypical clinical symptoms.Imaging combined with pathology and test of M.tuberculosis are the main methods to diagnose testicular tuberculosis.Regular anti-tuberculosis combined with appropriate surgical treatment is the effective treatment.The prognosis of testicular tuberculosis is good in most patients.

关 键 词：睾丸 结核病 诊断 治疗 预后 

分 类 号：R527.4[医药卫生—内科学]