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目的 :对肝结核的临床诊断方法及治疗加以探讨。方法 :利用病例总结和文献复习的方法。结果 :从1986年 11月~ 1998年 1月共收治经病理确诊的肝结核病人 5例 ,占同期收治结核病人的 0 .0 0 5 5 % ,主要临床表现为发热 ( 10 0 % )、腹痛 ( 80 % )、肝肿大 ( 80 % )。病理类型粟粒型 2例 ,局灶型 3例 ,无胆管炎型 ,除 1例死亡外 ,其余 4例经过 1.5年以上的抗结核治疗 ,并经随访预后良好。结论 :肝结核少见 ,其B超和CT表现缺乏特征性 ,唯一有效的确诊方法为肝活检 ,通过抗结核药物治疗和外科处理可以治愈。
Objective: To explore the clinical diagnosis and treatment of liver tuberculosis. Methods: Using case summary and literature review method. Results: From November 1986 to January 1998, 5 patients with pathologically confirmed liver tuberculosis were admitted, accounting for 0.0505% of the total tuberculosis patients admitted in the same period. The main clinical manifestations were fever (100%), abdominal pain (80%), hepatomegaly (80%). Pathological type miliary type in 2 cases, focal type in 3 cases, no cholangitis, in addition to 1 case of death, the remaining 4 cases after 1.5 years of anti-TB treatment and good prognosis after follow-up. CONCLUSIONS: Hepatic tuberculosis is uncommon and its features of B-ultrasound and CT are lacking. The only effective diagnostic method is liver biopsy, which can be cured by anti-tuberculosis drug treatment and surgical treatment.