女性生殖器结核33例临床分析

A clinical analysis on 33 patients with genital tuberculosis

目的探讨女性生殖器结核的诊断与治疗策略。方法回顾性分析北京大学第一医院1994年4月至2007年9月收治的女性生殖器结核患者33例的临床资料,综合文献进行阐述。结果患者诊断时年龄为(33.64±8.92)岁;不孕病史20例,占60.6%;北京市户口11例,外省市户口22例,占66.7%。27例行腹腔手术确诊,明确病理确诊20例,特异形态改变确诊7例;2例为分段诊刮病理确诊;4例为临床诊断。确诊时间的中位数为7d。除考虑陈旧性病变者,18例均接受药物或术后药物抗结核治疗。1例合并肺结核转院,其余健康出院。结论女性生殖器结核症状及辅助检查无特异性,诊断性腹腔镜检查有助于明确诊断。术后针对结核使用药物治疗可以有效控制病情。

Objective To investigate the diagnosis and treatment in patients with genital tuberculosis. Method Thirty- three cases of female patients with genital tuberculosis were reviewed in the First Hospital of Peking University between 1994 and 2007 retrospectively. Result The mean age of the patients at the time of diagnosis was 33.64 ±8.92 years ; 20 cases （60. 6% ） were with the history of infertility; 11 patients came from Beijing, and 22 patients （66.7%） came from other provinces. Totally 27 cases were diagnosed during surgery, 20 cases with pathology, 7 cases with the special manifestation ,2 cases with D＆C [ dilatation ＆ curettage ] and 5 cases with clinical features. The median clays of the diag- nosis were 7 days. Eighteen patients received anti-tuberculosis chemotherapy, except for the dated ones. One case was transferred to the tubercular hospital because of the lung tuberculosis. Others left hospital healthy. Conclusion There is no special symptom and assistant examination for female genital tuberculosis, but surgery is helpful to the diagnosis, especially with laparoscopy. It is effective to give chemotherapy after surgery.