肠系膜淋巴结结核的诊断和外科治疗

目的评价肠系膜淋巴结结核的诊断，手术治疗指征和效果。方法回顾性分析１９７６年７月～１９９７年７月两个医院手术治疗的肠系膜淋巴结结核５９例。结果术前确诊１４例，手术治疗并发症少，无手术死亡，效果良好。结论因肠系膜淋巴结结核患者临床表现无特异性，应结合实验室（如聚合酶链反应）、腹腔镜、ＣＴ和Ｂ超检查等结果综合分析。因肠系膜淋巴结结核引起急、慢性肠梗阻不能缓解、消化道出血，肠穿孔或肠瘘，腹腔巨大结核性脓肿不能控制或脓肿穿破腹壁形成窦道等需外科治疗。因有腹部包块诊断不明或不能除外肿瘤时亦需行剖腹术。术后应继续抗结核治疗

iagnosisandsurgicaltreatmentoftuberculosisofmesentriclymphnodesJiangJun,WangDaike.Gener alSurgeryDepartment,SouthwestHospital,ThirdMilitaryMedicalUniversity,Chongqing400038 Abstract ObjectiveToevaluatethediagnosis,operativeindicationandtherapeuticresul

Objective To evaluate the diagnosis, operative indication and therapeutic result of tuberculosis of mesentric lymph nodes. Method Fifty nine cases with tuberculosis of mesentric lymph nodes surgically treated at two hospitals from July 1976 to July 1997 were retrospectively analyzed. Result Only 14 cases were correctly diagnosed before operation. Operative treatment for the tuberculosis of mesentric lymph nodes represented a safe, effective treatment with few complications and no operative death. Conclusion Because patients with tuberculosis of mesentric lymph nodes show no characteristic manifestations, laboratory methods (eg. polymerase chain reaction), peritoneoscopy, CT scanning and B mode ultrosound techniques should also be considered for diagnosis of the disease. The acute or chronic ileus, hemorrhage of digestive tract, intestinal perforation or fistula, intra abdominal large tuberculous abscess and abdominal sinus caused by tuberculosis of mesentric lymph nodes should be surgically treated. The exploratory laparotomy also should be performed on the patients with abdominal mass or those whose diagnosis of neoplasm could not be ruled out. The postoperative antituberculosis chemotherapy should be continued to decrease the occurrence of complications.