25例肝结核临床分析

目的探讨肝结核的诊断和治疗措施。方法报道1999年1月~2005年1月收治确诊的肝结核病人25例,对其临床资料进行回顾分析。结果25例病人临床表现主要为发热、腹痛、腹胀和肝肿大,反复肝功能异常。病理类型粟粒型8例,结节型17例。5例手术切除治疗。所有病人都经过9~18月的抗结核治疗,经随访预后良好。结论肝结核临床表现和影像学表现多样,且无特异性,误诊误治率高。肝结核诊断需综合临床表现、实验室检查、影像学检查和病理检查,确诊手段主要是肝组织活检,系统性的抗结核治疗及选择性手术治疗是肝结核的主要有效治疗手段。

Clinical analysis on 25 cases with hepatic tuberculosis

Objective To explore the appropriate diagnosis and treatment for hepatic tuberculosis. Methods A total of 25 cases with hepatic tuberculosis confirmed were reported and analyzed. Results The main clinical manifestations were fever, abdominal pain, abdominal distension and hepatomegaly. All the patients were subjected to systemic anti-tuberculous therapy and some were received with sur- gical treatment. Their prognosis was good. Conclusion Hepatic tuberculosis diversified manifestations which, usually resulted in misdiagnosis,while liver biopsy was important in diagnosis and screening. Comprehending the clinical manifestation, laboratory examinations, significance of Ultrasound and computed tomography of the abdomen and the pathological features is helpful for the diagnosis, differential diagnosis and management of hepatic tuberculosis. Systemic anti - tuberculous therapy and selectivity surgical treatment are the main treatment.