胸壁结核诊断及治疗的研究现状

Research status of surgical diagnosis and treatment of chest wall tuberculosis

胸壁结核是一种常见的肺外结核,常发生于肺或胸膜结核,或与其他部位结核并存。由于早期临床表现不典型,故极易导致诊断及治疗不及时,最终病情进展表现为胸壁寒性脓肿,脓肿破溃后形成反复渗液经久不愈的慢性窦道。目前临床上对胸壁结核的诊断、治疗、预后存在系列问题,故本文对胸壁结核诊断包括 B 超、胸部 X 线片、CT 及正电子发射计算机断层显像/计算机断层扫描、结核感染 T 细胞斑点实验,病理检查等以及相关治疗包括内科药物治疗、外科治疗、局部治疗等进行综述。

Chest wall tuberculosis is a common extra-pulmonary tuberculosis, which often occurs in lung or pleura tuberculosis, or coexists with tuberculosis in other parts. The final manifestation of the disease is cold abscess on the chest wall, chronic sinuses with repeated exudation after the abscess is broken. At present, There were a series of problems in the diagnosis, treatment, and extremely prognosis of tuberculosis of the chest wall. Therefore, we reviewed the diagnosis of chest wall tuberculosis, including B-ultrasound, chest CT and positron emission tomography/computed tomography (PET/CT), tuberculous infectin of T cells spot test (T-SPOT TB), pathological examination. The related treatments including medical treatment, surgical treatment and other local treatment in order to better understand the chest wall tuberculosis.