罕见胸膜结核瘤1例  

A rare case of pleural tuberculoma

作　　者：肖行 陈海梅 邓小彦 XIAO Xing;CHEN Haimei;DENG Xiaoyan(Department of Critical Care Medicine,the First Affiliated Hospital of Hainan Medical University,Hainan,Haikou 570100,China;Department of Ophthalmology,the First Affiliated Hospital of Hainan Medical University,Hainan,Haikou 570100,China)

机构地区：[1]海南医学院第一附属医院重症医学科,海南海口570100 [2]海南医学院第一附属医院眼科,海南海口570100

出　　处：《中国医药科学》2023年第24期195-198,共4页China Medicine And Pharmacy

基　　金：海南省卫生健康行业科研项目(21A200046)。

摘　　要：作为结核性胸膜炎重要的临床和病理学特征之一,胸膜结核瘤多继发于结核性胸膜炎后在壁层或脏层胸膜的瘤样病灶。胸膜结核具有少菌性和结核分枝杆菌分布不均匀的特性,胸膜结核瘤有相同特性,使得培养阳性率偏低,导致诊断困难。且胸膜结核瘤可广泛累及肺部,部分病灶会不断增大、数目增多,严重影响肺功能,甚至发展至坏死及液化,液化坏死液漏入胸腔可导致结核性脓胸,积极有效的治疗可改善治愈率。本文报道1例以胸腔破裂为表现的罕见胸膜结核瘤病例,通过分析该患者的病史、临床征象、诊断及治疗过程,探讨胸膜结核瘤的诊断方法,同时分析胸膜结核瘤的临床表现、发病机制及治疗手段,以此为临床工作提供经验。As one of the important clinical and pathological features of tuberculous pleurisy,pleural tuberculoma is mostly secondary to tumor-like lesions in the parietal or visceral pleura after tuberculous pleurisy.Pleural tuberculosis has the characteristics of less bacteria and uneven distribution of mycobacterium tuberculosis,and pleural tuberculoma has the same characteristics,which makes the positive rate of culture,leading to difficult diagnosis.Moreover,pleural tuberculoma can widely involve the lungs,and some lesions will continue to increase in size and number,seriously affecting lung function and even resulting in necrosis and liquefaction.The leakage of liquefied necrotic fluid into the chest cavity can cause tuberculous empyema,but active and effective treatment can improve the cure rate.This paper reports a rare case of pleural tuberculoma manifesting with chest rupture.By analyzing the patient’s medical history,clinical signs,diagnosis and treatment process,this paper mainly discusses the diagnosis method of pleural tuberculoma,and analyzes the clinical manifestations,pathogenesis and treatment methods of pleural tuberculoma,so as to provide experience for clinical work.

关 键 词：胸膜结核瘤 发病机制 检测方法 临床征象 

分 类 号：R52[医药卫生—内科学]