肝结核的临床及病理特点

Clinicopathologic characteristics of hepatic tuberculosis

目的探讨肝结核的临床症状及诊断并分析其误诊原因。方法对1996年至2007年收治的14例肝结核患者的临床资料进行回顾性分析。结果有64.28%患者系经肝穿刺活检病理诊断。肝结核主要临床表现有发热(71.43%)、肝肿大(42.86%)、腹痛(35.71%)、贫血(57.14%)、肝功能损害(57.14%)及血沉增快(35.71%)。结论对不明原因发热伴肝脾肿大、腹痛、血沉增快、肝功能损害患者,应怀疑肝结核的可能。经皮肝穿刺活检病理检查是确诊的主要手段。

Objective To explore the clinical characteristics of hepatic tuberculosis. Methods The clinical data of 14 cases who were diagnosed as having hepatic tuberculosis by pathological examination were analyzed. Results 64.28% of the 14 patients was diagnosed by pereutaneous liver biopsy. Fever, hepatomegaly and abdominal pain were the major clinical manifestations and present in 71.43%, 42.86% and 35.71% of the patients respectively. Anemia, liver function damage and increased ESR were noted in the patients （57.14%, 57.14%, 35.71% respectively）. Conclusion The diagnosis should be considered in patients with unexplained fever associated especially with bepatomegaly or hepatosplcnomegaly, liver function damage and increased ESR. Percutaneous liver biopsy is the most valuable method to confirm the diagnosis.