24例肛周结核感染患者的临床分析

Clinical analysis of 24 patients with perianal tuberculosis infection

目的探讨肛周结核感染患者的临床特点。方法回顾性分析24例肛周结核患者的临床资料,应用Spearman秩相关分析抗结核治疗起始时间、结核菌素实验反应强度与创面愈合时间的相关性。结果24例肛周结核患者以中青年居多,且男性多于女性,城镇居民多于农村居民;影像学检查示合并肺结核4例;结核菌素阴性1例(4.16%),弱阳性7例(29.17%),阳性10例(41.67%),强阳性6例(25.00%);结核感染T细胞实验阳性20例。肛周结核患者抗结核治疗起始时间和创面愈合时间存在相关性(r_(s)=0.950,P<0.05)。肛周结核患者结核菌素实验结果和创面愈合时间无相关性(r_(s)=0.017,P>0.05)。结论结核菌素实验和结核感染T细胞实验诊断肛周结核的效果均不佳,结核菌素实验反应强度与创面愈合时间之间无明显关联性,肛周结核患者抗结核治疗起始时间和创面愈合时间之间存在相关性。患者发生肛周病变应当及时行相关检查排除肛周结核感染,以减少肛周结核病的漏诊,提高治疗效果。

Objective To explore the clinical features of patients with perianal tuberculosis infection.Methods The clinical data of 24 patients with perianal tuberculosis were retrospectively analyzed,and the correlations of the initiation time of anti-tuberculosis treatment and the tuberculin skin test reactivity with the wound healing time were analyzed by Spearman rank correlation.Results The 24 patients with perianal tuberculosis were mostly young and middle-aged people,and there were more males than females and more urban residents than rural residents.Imaging examinations showed 4 cases combined with pulmonary tuberculosis;in the tuberculin skin test,1 case(4.16%)was negative,7 cases(29.17%)weakly positive,10 cases(41.67%)positive,and 6 cases(25.00%)strongly positive;in the tuberculosis infection T cell test,20 cases were positive.There was a correlation between the initiation time of anti-tuberculosis treatment and wound healing time in patients with perianal tuberculosis(r_(s)=0.950,P<0.05).There was no correlation between the tuberculin skin test reactivity and wound healing time in patients with perianal tuberculosis(r_(s)=0.017,P>0.05).Conclusion The efficacy of the tuberculin skin test and tuberculosis infection T cell test are unsatisfied in the diagnosis of perianal tuberculosis,there is no an obvious correlation between the tuberculin skin test reactivity and wound healing time,but there is a correlation between the initiation time of anti-tuberculosis treatment and wound healing time in patients with perianal tuberculosis.Patients with perianal lesions should undergo relevant examinations in time to exclude perianal tuberculosis infection,so as to reduce the missed diagnosis of perianal tuberculosis and improve the treatment effect.