综合医院肺外结核101例临床分析

Clinical study on 101 extrapulmonary tuberculosis cases in general hospital

目的 通过对 10 1例肺外结核 (EPT)的临床分析提高对EPT的诊疗水平。方法 对上海市第五人民医院自 1994年 1月— 2 0 0 1年 1月收治的EPT患者的诊治情况 ,进行回顾性分析。结果共收治EPT 10 1例 ,老年人中发病较高 (33.7% ) ,最低 8.3% ,最高 2 0 .2 % ,平均 12 .8%± 4 .6 % ,发病部位以颈淋巴结结核最为常见 (4 2 .6 % ) ,其次是腹腔结核 (13.9% )和肾结核 (12 .9% )。其中病理确诊 70例 (6 9.3% ) ,病原菌确诊 16例 (15 .8% ) ,诊断性抗结核治疗及门诊随访 15例 (14 .9% )。共延误诊断 4 5例 (4 4.6 % )。采用规范化疗方案治疗的 6 2例 (6 1.4 % ) :不规范化疗方案治疗的 39例(38.6 % )。规范化疗治愈率 10 0 % ,不规范化疗复治率为 2 5 .6 %。结论 综合医院应重视EPT的诊治工作 ,采取综合诊断措施 ,做到早期诊断。

Objective To improve the diagnosis and treatment of extrapulmonary tuberculosis (EPT) through clinical analysis on 101 EPT cases.Methods The diagnosis and treatment situation of EPT patients treated in Shanghai Fifth People's Hospital,from January,1994 to January,2001 were studied retrospectively.Results The total number of EPT patients were 101,the most patients were old people (33.7%).The proportion of EPT overo all tuberculosis (TB) was 8.3%～20.2% and the mean rate was 12.8%±4.6%.The sites of TB primarily affected were the lymphadenitis of the neck (42.6%),abdominal cavity (13.9%) and kidney (12.9%).The final diagnosis confirmed by pathological findings,bacteriology test and diagnostic treatment and follow up was 69.3% (70),15.8% (16) and 14.9% (15) respectively.The number of patients with delayed diagnosis were 45 (44.6%).62 (61.4%) of the cases received standard chemotherapy and 39 (38.6%) received unstandard treatment.The cure rate of patients who receive standard chemotherapy was 100%.The rate of patients who need to receive treatment again was 25.6%.Conclusion The diagnose and treatment of EPT in general hospital should be paid attentions to ensure the patients be diagnosed and treated timely and by standardized treatment.