结直肠癌合并活动眭肺结核临床诊疗分析

Clinical analysis of colorectal cancer combined with active tuberculosis

目的探讨结直肠癌合并活动性肺结核患者的治疗方案。方法回顾性分析2011年9月至2017年1月西南医科大学附属医院治疗的8例结直肠癌合并活动性肺结核患者的临床资料。结果所有患者均于术前给予2-3周强化抗结核治疗后接受肿瘤根治性切除术,术后第2天起静脉输注异烟肼，胃肠功能恢复后继续用术前抗结核治疗方案强化治疗2个月后进行巩固治疗，抗结核巩固治疗的同时行FOLFOX4方案化疗6个疗程。术后发生肺炎3例，吻合口瘘1例；术后在抗结核巩固治疗期间无结核播散，无死亡病例。结论结直肠癌合并活动性肺结核患者术前给予2-3周抗结核治疗后可行肿瘤根治性手术；术后在抗结核巩固治疗期间同时行肿瘤辅助化疗是安全可行的。

Objective To explore the treatment methods for colorectal cancer patients combined with active tuberculosis.Methods The clinical data of 8 cases of colorectal cancer combined with active tuberculosis from September 2011 to January 2017 in the Affiliated Hospital of Southwest Medical University were analyzed retrospectively.Results All the patients received tumor radical resection after given intensive anti-tuberculotherapy for 2 to 3 weeks. From the second day after surgery, isonicotinyl hydrazide was done through intravenous infusion. When gastrointestinal function was restored, the preoperative anti-tuberculosis treatment was reused. After 2 mouths, consolidation therapy was done. There were 3 cases of complicating pneumonia and 1 case of complicating anastomotic fistula after surgery. Six courses of FOLFOX4 chemotherapy combined with anti-tuberculosis consolidation treatment were carried out for all the patients. No tuberculosis dissemination or death case occurred.Conclusions After given anti-tuberculotherapy for 2 to 3 weeks, the colorectal cancer patients combined with active tuberculosis could receive tumor radical resection. It is safe and feasible to carry out assisted chemotherapy for tumor during the consolidation anti-tuberculotherapy.