喉结核68例临床分析

目的:探讨喉结核的临床特征和诊断要点.方法:对68例喉结核的临床资料做回顾性分析.结果:本病主要症状有声嘶、咽干燥感、喉痛、吞咽障碍等,全身症状不明显.声带为其主要病变部位,病变类型以增生型为主,38例喉部多部位病灶中55.26%(21/38)并发活动性肺结核,30例喉部单一病灶中63.33%(19/30)肺部正常.58例经活体组织病理检查证实为结核,10例未行活检,但胸片均提示有活动性肺结核.初诊误诊率为73.52%.全部患者确诊后均进行抗结核治疗,疗效满意.结论:当今喉结核临床特点较以往变化较大,全身症状不明显,局部病变形态不典型,临床易发生漏诊、误诊.活组织病理检查是本病确诊的重要手段.

Clinical analysis on 68 cases of laryngophthisis

Objective：To discuss the clinical features and diagnosis points of laryngophthisis.Methods：We analyzed the clinical data of 68 cases laryngophthisis in our center from Jan.1997 to Jan 2007 retrospectively.Results：Among 68 cases,54 cases visited hospital by laryngeal disease in E.N.T.department firstly.The main symptoms included hoarseness,pharyngoxerosis,pharygalgia,dyphgia and so on.The general symptoms were not obvious.The main site of pathological changes was vocal cords and the main type of pathological changes was hyperplasia.55.26% sufferers of 38 cases,who were multi-part focus,were complicated by active tuberculosis.63.33% sufferers of 30 cases,who were single focus,were normal in lung.58 sufferers,who were checked through pathologic examination by living body tissue,were approved to be tuberculosis.10 cases were not checked,but it is pointed out that there was active phthisis by X-ray.The rate of misdiagnosis was 73.52（50/68） for the first diagnosis.All sufferers were cured by anti-phthisis’ treatment after definite diagnosis and were satisfied the curative effect.Conclusion：The clinical features of laryngophthisis are quite different from those in the past.The general symptoms are not obvious.The local pathological change is not representative.Missed diagnosis and misdiagnosis could easily happen in clinic.The pathologic biopsy is the important measure for the diagnosis.