社区医院因症就诊发现肺结核合并耳鼻咽喉结核的临床分析

Clinical diagnosis of pulmonary tuberculosis associated with tuberculosis in ear,nose and throat in community hospital

目的探讨结核病在耳鼻咽喉和颈部的表现,提高肺结核诊断率。方法回顾性分析138例已经菌培养抗酸染色,病理学检查或诊断性治疗确诊为肺结核但有误诊或合并耳鼻喉及颈淋结其他病症患者的临床表现,寻找无典型肺结核症状体征病人的耳鼻咽喉症状体征。结果73.77%的病例首次就诊时误诊为耳鼻咽喉或淋巴结慢性炎症,16例误诊为良性肿瘤,全部病例经正规全程抗结核药物治疗后痊愈。结论了解不典型肺结核在耳鼻咽喉的临床表现可减少误诊漏诊,提高肺结核患者的发现率。

Objective To explore elinieal manifestations of tubereulosis in ear, nose, throat and neek in order to raise the rate for deteetion of pulmonary tuberculosis in these patients. Methods The clinical data of 138 patients with misdiagnosis or associated with tuberculosis in ear, nose, throat and cervical lymph nodes were retrospectively studied and analyzed. The diagnosis of pulmonary tubereulosis in these eases were confirmed by positive myeobaeterium culture or acid - fast staining, pathological examination or diagnostic treatment. The clinical manifestations of tu- bereulosis in areas of ear, nose and throat were studied for deteetion of atypieal pulmonary tubereulosis. Results 73.77% of these eases were misdiagnosed as ehronie inflammation in ear, nose, throat, or lymph nodes at the first visit in hospital. Sixteen of them were misdiagnosed as benign tumors. All these eases were cured after regular anti - tuberculosis treatment. Conclusion The understanding of clinical manifestations of tubereulosis in ear, nose and throat in patients with atypical pulmonary tuberculosis can reduce the rate of misdiagnosis. Thus, it may raise the rate of diagnosis of pulmonary tubereulosis in patients.