65例肠结核临床分析

Clinical analysis of 65 cases of intestinal tuberculosis

目的探讨肠结核的诊断及治疗,以减少肠结核的误诊、误治。方法回顾分析近10年来65例肠结核患者的肠镜及临床资料。结果肠结核以腹痛、大便形状改变为主要临床表现,可伴有乏力、低热、消瘦、血便,易误诊为肠肿瘤、克罗恩病等。结论结肠镜检查结合病变组织活检加结核分枝杆菌特殊染色是诊断肠结核最有效的方法,结合胸片、结核菌素纯蛋白衍生物试验可提高诊断率。大多数患者药物治疗可治愈,少数患者因严重并发症行手术治疗。

Objective To investigate the diagnosis and treatment of intestinal tuberculosis so as to reduce the clinical misdiagnosis and mistherapy of the disease. Method A retrospective analysis was perfor,ned on colonoscopic findings and clinical data of 65 cases of intestinal tuberculosis in our hospital in the past 10 years. Results The main clinical manifestations of intestinal tuberculosis were abdominal pain and the changes of stool shape, and the other manifestations probably accompanied were fatigue, low-grade fever, weight loss and bloody stool. The disease was easily misdiagnosed as intestinal tumor, Crohn＇s disease and so on. Conclusions The combinated methods of colonoscopy, biopsy and special staining for Mycobacterium tuberculosis are the most effective for the diagnosis of intestinal tuberculosis. Chest X-ray and tuberculin or purified protein derivative test may improve the diagnostic rate. Most patients can be cured with drug treatment, and a small number of patients with severe complications has to receive surgical treatment.