临床症状不典型的血行播散型肺结核的X线分析

目的对临床症状不典型的血行播散型肺结核的X线表现进行分析。方法对9例临床症状不典型的血行播散型肺结核的X线平片表现进行回顾性分析。结果9例均无高热、盗汗、咯血临床症状，而以不规则发热、消瘦、乏力、咳嗽、咯痰等为主要表现。X线检查6例双肺呈弥漫性粟粒样或结节样改变，其中1例伴有胸膜炎；另外3例双肺肺纹理增粗呈网织样改变，经随访胸片观察，逐渐表现为弥漫性粟粒样改变。结论对于临床症状不典型而X线检查双肺呈弥漫性粟粒样改变或双肺肺纹理呈网织样改变患者，均应考虑血行播散型肺结核的可能，必须短期复查X线胸片。本病确诊有赖于痰检发现结核杆菌。

X-ray analysis of hematogenous disseminated pulmonary tuberculosis in cases with untypical clinical symptoms

Objective To analyze X ray characteristics of hematogenous disseminated pulmonary tuberculosis with untypical clinical symptoms.Methods The imagings of X ray plain film from 9 cases with untypical clinical symptoms of hematogenous disseminated pulmonary tuberculosis were studied retrospectively. Results There were no typical clinical symptoms of Hematogenous ematogenous disseminated pulmonary tuberculosis such as hyperpyrexia, night sweat, hemoptysis, and so on. Instead, there were unregular fever, magersucht, hypodynamia, cough, and expectoration. Among 9 cases, there were 6 cases with diffuse military changes or nodulated changes distributed in two lung fields, 1 of those with pleuritis. The other three cases had increased lung markings of reticular structure in two lung fields. As time went, the reticular structure became diffused military changes. Conclusion The diagnosis of hematogenous disseminated pulmonary tuberculosis with untypical clinical symptoms will be confirmed when diffuse military changes or reticular structure are distributed in two lung fields. The patients should be examined by X ray again within a short period of time. Hematogenous disseminated pulmonary tuberculosis will be confirmed when mycobacterium tuberculosis is positive in sputum examination.