肠结核26例诊断与治疗的临床分析

目的:探讨肠结核的诊断要点及治疗特殊性,减少临床误诊误治.方法:回顾性分析普外科13年来26例肠结核病例的诊治资料. 结果:入出院诊断符合的仅5例(19.2%).术前行B超、CT、全消化道钡透或结肠镜检查的14例(53.8%)中,提示结核的仅2例(14.3%),大部分怀疑腹腔肿瘤或诊断为不能定性的腹腔肿块.手术24例,开腹后能肉眼确诊的2例(8.33%),另22例经术中快速病理切片得以确诊.所有手术患者术后均抗痨治疗,无并发症发生. 结论:肠结核临床症状不典型,临床医生对本病缺乏警惕性常导致较多的误诊误治.手术治疗有其特殊性,根据开腹所见决定手术方式,效果较好.

The clinical analysis of the diagnosis and therapy of 26 cases with intestinal tuberculosis

Objective: To study the diagnostic essentials and therapeutic specificity of intestinal tuberculosis. Methods: To retrospectively analyze the diagnosis and therapy of 26 cases with intestinal tuberculosis in the department of general surgery in the past 13 years. Results: Of 26 patients, only 5 cases' admitting diagnosis accorded with their discharge diagnosis(19.2%). Among 14 (53.8%) cases undergone B ultrasonograph, computer tomography(CT), total alimentary tract barium meal perspective and colonoscopy before operation, only 2 (14.3%)were indicative of intestinal tuberculosis, and the majority of them were suspected abdominal neoplasm or diagnosed with un-qualitative abdominal mass. Of 24 undergone operation, only 2 (8.33%)could be definitely diagnosed with intestinal tuberculosis with naked eyes during operation. The rest obtained the same result by rapid pathological sections during operation. Besides, no complications occurred among the 20 patients who informally undergone post-operational anti-tuberculosis therapy. Conclusion: Atypical clinical symptoms of intestinal tuberculosis and clinicians' lacking of alertness of this disease frequently result in more misdiagnosis and mistreatment. Surgical procedures should based on the finding of laparotomy, then the surgical outcome is encouraging.