喉结核63例临床分析

Clinical analysis of 63 patients with laryngeal tuberculosis

目的探讨喉结核的临床特征,以提高临床医师对喉结核的认识。方法回顾分析63例喉结核病例的临床资料。声嘶是喉结核患者的主要临床症状,占73.02%,全身症状不明显。所有患者经胸部X线片检查,痰中找抗酸杆菌及组织病理学检查确诊后,送结核病医院治疗。随访6～36个月。结果所有病例中,胸部X线片发现活动性肺结核14例;病理检查证实为陈旧性肺结核36例,13例正常。痰中找到抗酸杆菌1例。所有病例经病理检查主要表现均为肉芽性病变,声带病变累及者多于其他部位段累及者(χ2=21.38,P<0.01)。初诊误诊44例,误诊率为69.84%。结论喉结核的发病率有所增高,在临床工作中应该提高对本病的认识,以减少误诊。

Objective To investigate the clinical features of laryngeal tuberculosis. Methods Sixty-three patients with laryngeal tuberculosis were retrospectively studied. Hoarseness was the most frequent complaint, counting 73.02%, while the systemic symptoms were relatively rare. All patients were transferred to the tuberculosis hospital after the final diagnosis by X-ray, acid-fast bacilli and pathology test, who were followed up for 6 to 36 months. Results Among 63 patients, 50 showed pulmonary tuberculosis （including active in 14 cases and obsolete in 36 cases）, and 13 showed negative chest X-ray results. Acid fast bacilli were found in 1 case. The pathologic characteristics was granulation. The lesions commonly involved the vocal cord （ χ^2= 21.38, P 〈 0.01 ）. The incidence of misdiagnosis was 69.84% （44 cases）. Conclusions The incidence of laryngeal tuberculosis was rising,and attention should be paid to the clinical feature of laryngeal tuberculosis in order to reduce the rate of misdiagnosis. （ Chin J Ophthalmol and Otorhinolaryngol, 2009,9：97-98）