肠结核在大肠镜下的表现及分型

COLONOSCOPIC FINDINGS AND TYPING OF INTESTINAL TUBERCULOSIS

为使肠结核肠镜下分型更合理，文章总结了３９例肠结核在大肠镜下的表现，在溃疡型、增生型和混合型（溃疡增生型）的基础上提出了炎症型。炎症型在肠镜下的表现是粘膜充血、水肿、质脆，血管纹模糊，呈点状或片状糜烂，附黄白色粘液渗出物或霜样白苔，无溃疡和增生性表现。活检病理检查示粘膜结核。炎症型是肠结核的早期病变，活检成功率高。讨论认为炎症型符合肠结核的病理变化规律，是客观存在的，重视炎症型改变可使肠结核在肠镜下获得较早期诊断。

This paper presents up the colonoscopic findings of 39 proven cases of intestinal tuberculosis,21 females,and 18 males,the mean age being 40 7 years(ranging 9 to 71 years).Inflammatory type is proposed.The colonoscopic findings of this inflamatory type include byperemia,edema of involved mucosa with a friable and erosive appearance of the intervening mucosa,covered by a layer of fibrino purulent exudate or frosty white mucus.Colonoscopy failed to ulceration or hypertrophy,however biopsy could prove mucosal tuberculosis.As the inflamatory type being the early stage of intestinal tuberculosis with lesions localized to mucosa only,the diagnosis by biopsy is quite certain.It is considered that the proposal of inflamatory type by the authors would be the basis of establishing an early diagnosis of intestinal tuberculosis under colonoscope.