肠结核诊断及其外科手术方法探讨（附23例肠结核外科诊治分析）

目的 探讨目前肠结核的诊断和外科治疗方法。 方法 回顾分析2008年1月至2010年12月吉林大学第一医院外科治疗23例肠结核患者的临床治疗情况。 结果23例患者中，术前通过肠镜病理诊断肠结核4例；结合病史、影像学检查、实验室检查疑诊肠结核12例，其余7例因怀疑腹腔肿瘤或需急诊手术未能术前确诊。所有患者均经术后病理确诊为肠结核，术后接受抗结核药物治疗，停药后随访1年，除3例失访外，治愈13例，好转7例，其中3例出现粘连性不全肠梗阻症状（3/7），2例排便习惯改变 (2/7)，2例有间断腹部隐痛(2/7)。 结论 早期诊断、正规的抗结核药物治疗及正确地选择手术适应证、术式，可以提高肠结核的治疗效果，是成功治疗肠结核的关键。

The exploration of the diagnosis and surgical therapy of intestinal tuberculosis based on 23 clinical cases

Objective To explore clinical diagnosis and surgical treatment of intestinal tuberculosis based on 23 clinincal cases. Methods The clinical data of 23 patients with intestinal tuberculosis were collected in our hospi- tal from 2008. 1 to 2010. 12. Results Twenty-three patients, 4 intestinal tuberculosis cases were diagnosed by colonoscopy pathology,combining with the medicial history, radiographic and laboratory examination, 12 of them were suspected cases, the rest 7 which couldn＇t be distinguished with abdominal tumor or needed emergency surgery failed to make a definite diagnosis before operation. All cases were treated with anti-tuberculosis drugs postopera- tively, 20 of them were cured or improved except 3 couldn＇t be followed up. Conclusion Early diagnosis, stand- ard antituberculous therapy, and optimal surgical operation are benefit to the intestinal tuberculosis treatment.