86例腱鞘结核临床特点误诊原因及治疗转归分析

目的]分析总结腱鞘结核的病例特点、治疗经过，探讨该病的误诊影响因素及治疗转归，从而为临床诊治提供循证依据。方法]回顾分析1994年1月～2006年6月间文献报道86例腱鞘病例，就其性别、年龄、病灶部位、临床表现、治疗经过及效果等进行统计学分析。结果]高发年龄为30～49岁，占65％。男女性别比基本为1：1，发病部位右侧（67％）明显高于左侧（30％），以肿胀、压痛、活动障碍为主要表现，误诊率88％，复发率1．2％。结论]临床症状体征不典型、实验室检查非特异性是导致腱鞘结核误诊的主要原因。局部病灶完整切除并全身化疗和（或）局部应用化疗药是治疗腱鞘结核的最佳治疗方案，复发率低。

Analysis of clinical manifestation, misdiagnosis and prognosis in patients with tendious sheath tubercular

Objective]To analysis the clinical manifestation and treatment of tendious sheath tubercular,probe the influencing factor of misdiagnosis and effect of treatment,in order to offer evident base for diagnosis and treatment.Method]The material of 86 cases(from January 1994 to Jun 2005)were reviewed and statistically analyzed including sex,age,nidus region,clinical manifestation,method and effect of treatment,etc.Result]65% of the cases were 30~49 years old.Sexual difference was not significant.Nidus region in right side was apparently higher than that in left(67%:30%).Major manifestation was edema,tenderness and mal-motion.The misdiagnosis rate and recurrent rate were 88% and 1.2%.Conclusion]Untypical clinical symptoms and sign,non-special laboratory examinations lead to misdiagnosis.The effective treatment includes integrity excision,local and general chemotherapy,which made recurrent rate low.