胃结核胃镜和X线诊断探讨

The study of the diagnostic value of X-ray rarium meal examination and gastroscopy for gastric tuberculosis ulcer.

目的 探讨胃结核性溃疡的临床特点及胃镜和X线诊断价值。方法 对 15年间经手术和术后切片确诊的 12例胃结核性溃疡回顾性研究分析。结果 ①以青壮年多见 ,<45岁占 75 % ;②胃结核性溃疡长径≥ 1 5cm 9例(75 % ) ,单发溃疡 10例 ,多发溃疡 2例 ;③溃疡分布 ,胃窦 9例 (占 75 % ) ,胃体 2例 (占 16 7% ) ,胃底 1例 (占 8 3 % ) ;④ 12例胃结核性溃疡X线诊断恶性溃疡 6例 ,胃溃疡 6例 ,报告误诊率 10 0 %。胃镜诊断胃结核 2例 (占 16 7% ) ,巨大溃疡及恶性溃疡 10例 (占 83 3 % )。结论 今后应结合临床资料分析 ,多种检查 ,内镜直视并应用染色胃镜和放大胃镜鉴别诊断 ,多方位加溃疡处多块、大块活检 。

Objective To study the clinical features of gastric tuberculosis ulcer and the diagnostic value of barium meal examination and gastroscopy for it. Methods A retrospective study was carried out in 12 patients with gastric tuberculosis ulcer confirmed pathologically after operation during past 15 years. Results ①Gastric tuberculosis ulcer usually occurred in the young and adults under 45 years old(75%);②The chiameter of gastric tuberculosis ulcer was≥1.5cm in 9 cases(75%),the ulcer was single in 10 cases;③The location of ulcer was at the antrum of stomach in 9 cases(75%),at the body in 2 cases(16.7%),at the fundus in 1 case(8.3%);④X-Ray barium meal diagnosed 6 cases as malignant ulcer and 6 cases as gastric ulcer and the mosdiagnostic rate was 100%,gastroscopy diagnosed 2 cases as gastric tuberculosis(16.6%)and 10 cases as giant ulcer and malignant ulcer(83.3%). Conclusions Multiple examining methods(dyeing gastroscopy;enlarged gastroscopy,and so on),multi-site biopsy,combined with clinical data may reduce mosdiagnostic rate.