女性盆腔结核误诊九例分析

Misdiagnosis Analysis of 9 Patients with Female Pelvic Tuberculosis

目的探讨女性盆腔结核的诊治要点,以减少误诊误治。方法对我院2000年1月—2010年12月收治的9例女性盆腔结核误诊病例的临床资料进行回顾性分析。结果本组表现为腹痛、腹胀各6例,消瘦、发热各3例,阴道不规则流血2例,痛经并不孕、尿频并尿急各1例。查体发现附件肿块8例,局部压痛5例,子宫增大、腹腔积液各1例。9例均误诊,诊断盆腔肿物(卵巢癌可能性大),误诊时间10 d～2年。9例均行剖腹探查手术,术中及术后病理检查诊断为盆腔结核,其中1例合并右侧卵巢良性畸胎瘤。结论女性盆腔结核临床表现无特异性,易误诊。综合运用各种医技检查手段,提高对该病的警惕性,必要时行剖腹探查术,可减少误诊。

Objective To explore the diagnosis and treatment of female pelvic tuberculosis and to reduce misdiagnosis rate. Methods Clinical data of 9 misdiagnosed patients with female pelvic tuberculosis during January 2000 and December 2010 in our hospital were retrospectively analyzed. Results Abdominal pain and abdominal distention were found in 6 patients, emaciation and fever occurred in 3 patients, 2 of irregular vaginal bleeding, dysmenorrhea with infertility and urinary frequency with urinary urgency occurred in l patient. Body examination showed adnexauteri mass in 8 patients, local tenderness in 5 patients, hysterauxesis and seroperitoneum in 1 patient respectively. All patients were misdiagnosed as having pelvic goiter and were suspected of ovarial cancer, and the misdiagnosis time was 10 days -2 years. Exploratory laparotomy was performed for all patients, preoperative and postoperative pathologic diagnoses were pelvic tuberculosis, including 1 patient combined with the right ovary benign teratomas. Conclusion Clinical manifestations of female pelvic tuberculosis are nonspecifie. Clinicians may reduce misdiagnosis rate by comprehensively using various auxiliary examinations, strengthening the awareness and applying necessary exploratory laparotomy.