喉结核18例临床分析

doi:10.6040/j.issn.1673-3770.0.2016.380

摘要/Abstract

摘要： 目的分析18例喉结核患者的临床特征及诊断要点。方法回顾性分析天津市第一中心医院收治的18例喉结核患者的临床资料。结果主要症状包括声音嘶哑、咽痛、咽异物感、吞咽困难、咯血及咳嗽等,全身症状不明显。喉部特征性表现:喉部苍白水肿、增生结节、溃疡糜烂。经胸CT或胸部X线平片证实,10例患有肺结核,但未经规范抗痨治疗。9例行痰涂片抗酸染色,阳性1例。14例行病理诊断,发现阳性杆菌6例,阳性率42.9%。所有患者确诊后转结核病防治所行抗痨治疗,发现喉结核合并喉癌1例。结论喉结核的发生与肺结核密切相关,天津地区肺结核经呼吸道的直接传播仍是喉结核的主要感染途径;患者全身症状不明显,易造成误诊、漏诊;纤维喉镜下或全麻手术下病理活检是喉结核确诊的主要手段。

关键词: 喉结核, 诊断, 治疗

Abstract: Objective To analyze the clinical characteristics and diagnostic points of 18 patients with laryngeal tuberculosis. Methods The clinical data of 18 patients with laryngeal tuberculosis were retrospectively analyzed in Tianjin First Center Hospital. Results The major manifestations of laryngeal tuberculosis include hoarseness, sore throat, foreign body sensation in the throat, dysphagia, hemoptysis and cough, but the general symptoms were not obvious. The throat was characterized by pale swelling, proliferative nodules, and ulcerative erosion. According to the results of chest computed tomography(CT)or X radiography, 10 patients had pulmonary tuberculosis, but did not receive anti-tuberculosis treatment. One of 9 patients undergoing sputum smear acid-fast staining was shown positive. Through pathological examination, 6 out of 14 patients were found gram-positive bacteria, and the positive rate was 42.9%. There was 1 patient with laryngeal tuberculosis and laryngocarcinoma after all the diagnosed patients were given anti-tuberculosis treatment in Tuberculosis Dispensary. Conclusion Laryngeal tuberculosis is closely related to lung tuberculosis, and is easily caused by the respiratory tract of patients with pulmonary tuberculosis in Tianjin. Laryngeal tuberculosis tends to be missed diagnosis and misdiagnosed due to atypical general symptoms. Pathological biopsy under the fibrolaryngoscope or general anesthesia should be taken as a major method to make the accurate diagnosis.

Key words: Diagnosis, Laryngeal tuberculosis, Therapy

中图分类号:

R767.1

扈启迪,李耀君. 喉结核18例临床分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 85-89.

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