胰腺结核11例临床分析

Pancreatic tuberculosis:report of 11 cases

目的 加强对胰腺结核的认识 ,提高正确诊断率 ,使其得到合理治疗。方法 回顾性分析我院在 1984～ 1994年收治的胰腺结核 11例。结果 本组胰腺结核临床表现 :发热 6例、腹痛 7例、腹部包块 3例、黄疸 2例、盗汗 3例、体重下降 5例等。根据临床表现确定诊断 1例 ;经B型超声引导细针穿刺细胞学检查确定诊断 1例 ;其余 9例行开腹探查 ,由穿刺或术中病理学检查确定诊断。全部病例接受抗结核治疗。得到随访 9例 ,随访 2～ 10年 ,全部治愈无复发。结论 发热、腹痛、影像学检查胰腺有限局性病灶的病人 ,应考虑胰腺结核的诊断。进一步应行B型超声或CT引导下细针穿刺检查。抗结核治疗可以治愈胰腺结核。

Objective[WT5”BZ] To improve the diagnosis and treatment of pancreatic tuberculosis. [WT5”HZ]Methods[WT5”BZ] 11 cases of pancreatic tuberculosis were retrospectively reviewed in this paper.[WT5”HZ]Results[WT5”BZ] In our cases, pancreatic tuberculosis presented with a wide spectrum of symptoms, these included fever of unknown origin in 6, upper abdominal pain in 7, a mass in the epigastrium in 3, obstructive jaundice mimicking pancreatic carcinoma in 2, night sweat in 3 , weight loss in 5. Pancreatic tuberculosis was confirmed in one by clinical symptoms and investigations, in another one by BUS-guided fine needle aspiration cytology, in others by intraoperative biopsy and/or fine needle aspiration cytology. All patients received antituberculosis therapy. 9 cases were followed up and all were healthy without recurrence.[WT5”HZ]Conclusions[WT5”BZ] Pancreatic tuberculosis should be considered as a diagnostic possibility in patients presenting with fever and abdominal pain and who show focal intrapancreatic lesions on imaging. In such patients, BUS or CT guided fine needle aspiration may help in reaching a diagnosis. Pancreatic tuberculosis can be cured by antituberculotics. [WT5”HZ]