78例肺结核合并喉结核临床分析

目的 探讨肺结核合并喉结核的临床特征,提高肺结核合并喉结核的诊疗水平.方法 回顾性分析2016年4月至2019年8月入住我院的78例肺结核合并喉结核患者的临床资料,包括:电子支气管镜、胸部CT、活检病理、抗酸染色涂片、结核菌培养、结核菌分子检测等结果,同时了解是否合并其他部位结核、诊疗经过是否存在误诊,并对抗结核方案及...

Clinical analysis of 78 cases of pulmonary tuberculosis complicated with laryngeal tuberculosis

Objective To explore the clinical features of pulmonary tuberculosis complicated with laryngeal tuberculosis and improve the diagnosis and treatment level of pulmonary tuberculosis complicated with laryngeal tuberculosis.Methods The clinical data of 78 patients with tuberculosis complicated with laryngeal tuberculosis admitted to our hospital from April 2016 to August 2019 were retrospectively analyzed,including:electronic bronchoscopy,chest CT、biopsy pathology,acid-fast staining smear,tuberculosis culture,molecular detection of tuberculosis bacteria and so on.At the same time,whether there was tuberculosis in other parts,whether there was misdiagnosis,and the anti-tuberculosis program and follow-up of curative effect were analyzed.Results In addition to expectoration,chest tightness,low fever,night sweating and fatigue,pulmonary tuberculosis patients often had typical laryngeal symptoms,mainly characterized by hoarseness(47 cases,60.26%),sore throat(24 cases,30.77%)and foreign body sensation in pharynx(5 cases,6.41%).Microscopically,17 cases(21.79%)were confined to one site,61 cases(78.21%)were involved in two or more sites,and 48 cases(61.54%)were involved in vocal cords.The main types of laryngeal tuberculosis were granulation proliferation(14 cases,17.95%),inflammatory infiltration(15 cases,19.23%),ulcer necrosis(10 cases,12.82%),mixed type(39 cases,50.00%).Pulmonary tuberculosis complicated with laryngeal tuberculosis patients often had other parts of tuberculosis,tracheobronchial tuberculosis,cervical lymph node tuberculosis and intestinal tuberculosis.Due to lack of effective cognition,pulmonary tuberculosis complicated with laryngeal tuberculosis was prone to clinical misdiagnosis,mainly misdiagnosed as pharyngitis and vocal cord polyp.After regular systemic anti-tuberculosis treatment,the laryngeal symptoms disappeared and the prognosis was good.The average course of treatment was 14.41±2.99 months,which was longer than that of simple pulmonary tuberculosis group.The difference was statistically significant.Conclusion Pulmonary tuberculosis complicated with laryngeal tuberculosis often has hoarseness,sore throat and foreign body sensation throat symptoms.Laryngeal lesions are widely distributed in mixed type.Because of lack of effective cognition,it is often misdiagnosed clinically.Once diagnosis,through the regular anti-tuberculosis treatment can obtain good curative effect.