| 脾结核21例临床分析 |
| 投稿时间：2010-12-29 修订日期：2011-01-25 点此下载全文 |
| 引用本文：金春,朱敏.脾结核21例临床分析[J].医学研究杂志,2011,40(9):149-150 |
| DOI：
|
| 摘要点击次数: 1011 |
| 全文下载次数: 914 |
|
|
| 中文摘要:目的探讨脾结核的临床表现、诊断及治疗措施。方法对21例脾结核患者的临床资料进行回顾性分析。结果21例患者中，有发热症状者16例（76.2%），热程3天~1年不等，2周~3个月占81.3%。有腹胀、腹痛症状为12例（571%），乏力、食欲不振、消瘦、盗汗等结核中毒症状者18例（85.7%），以停经为症状1例。脾切除术后病理确诊2例，浅表淋巴结活检术后组织病理确诊2例，痰抗酸染色阳性确诊4例，胸腰椎手术病灶清除脓肿病理确诊2例，肠镜活检病理确诊1例，骨髓活检病理确诊1例。还有9例是结合患者临床表现及各项检查明确。21例患者中19例接受正规抗结核保守治疗，患者临床症状好转，血沉恢复正常。2例因经济原因放弃治疗，但经前期治疗临床症状有所改善。结论脾结核以长程发热为突出表现，误诊率高，诊断可结合其他脏器（如肺脏、淋巴结）病变明确。早期发现及系统性抗结核治疗可避免行脾切除术。 |
| 中文关键词:脾结核 诊断 治疗 |
| |
| Clinical Analysis of 21 Cases of Splenic Tuberculosis |
|
|
| Abstract:ObjectiveTo investigate the clinical features,diagnosis and treatment of splenic tuberculosis.MethodsThe clinical data of 21 cases of splenic tuberculosis were retrospectively analyzed.ResultsFever occured in 16 of 21 patients(76.2%),and the duration was 3 days to 1 year.In 81.3% patients,fever lasted for 2 weeks to 3 months.12 patients (57.1%) had the symptoms of abdominal pain and distension. The infection-toxic manifestations caused by tuberculosis such as loss of appetite,general fatigue,marasmus,night sweat occured in 18 patients(85.7%).Amenorrhea was found in 1 paitents.2 cases of splenic tuberculosis were diagnosed by the postoperative pathology of splenectomy.2 patients were found to be splenic tuberculosis by biopsy of superficial lymph node,4 by the positive result of acid-fast bacillus test in sputum,2 by the complicating lumbar spine tuberculosis.1 patient was identified by biopsy of enteroscope and 1 by bone marrow biopsy.The other 9 cases of splenic tuberculosis were diagnosed by the clinical manifestations and laboratory tests.19 of 21 patients received anti-tuberculosis chemotherapy for more than half a year.Only 2 patients gived up the treatment for financial reasons,which physical situation had been improved by the therapy.ConclusionThe long lasting fever is the major manifestation of splenic tuberculosis.Misdiagnosis rate is high.The diagnosis can be clarified when it is complicated with other organ′s tuberculosis,such as pulmonary and lymphatic tuberculosis.Early detection and systemic anti-tuberculosis therapy can make the splenectomy evitable. |
| keywords:Splenic tuberculosis Diagnosis Therapy |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
