胸膜结核球的诊断和治疗(附31例临床分析)

目的 探讨胸膜结核球临床及X线特点?方法 分析 1.970～ 1.998年收治的 3.1例胸膜结核球?结果 1.19例既往有明确的渗出性胸腔积液史 ( 61.3 % ) ,经治疗胸水吸收 ,数月至数年后发现球形病灶?2.24例正侧位胸片有不同程度的胸膜增厚?钙化及肋膈角改变 ( 77.4 % )? 3 本组误诊为肺癌?胸膜间皮细胞瘤及错构瘤等占 4.52 % ( 1.4 / 3.1 )?结论 胸膜结核球结合完整的病史 ;依靠切线位片?CT及胸部透视即可诊断?经积极的抗结核治疗可避免手术?

Diagnosis and treatment of tuberculoma of pleura

Objective To study the clinic and X-ray characteristics of tuberculoma of pleura.Methods Analyzed retospectively 31 cases of pleura tuberculoma treated during 1970～1998.Results 1.61.3% of the patients had an explictly exudative pleural effusion history,after treatment effusion absorption and months or years later,a spherical shadow appeared. 2.77.4% chest X-ray had a pleural thichening,cacification and costophrenic angle change.3.45.2% misgnosed as lung cancer,mesothelioma and hamartoma.Conclusion Dignosis of pleural tuberculoma need an integrated history,tangential position X-ray film?CT and fuoroscopy of chest and sufficient antituberculous treatment may avoid operation.