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目的探讨咽喉部梅毒的鉴别和诊断要点。方法回顾性分析2011年2月-2015年1月在本院耳鼻咽喉科以咽喉症状及咽喉部黏膜损害为特征首诊的21例Ⅱ期梅毒患者的临床资料,包括纤维喉镜检查结果、皮损部位和形态及临床特征等。结果该21例患者主要病损区域均是以扁桃体和软腭为中心的口咽部,累及舌根者8例,伴喉部黏膜受损者5例。病损黏膜均表现为周围伴有红色充血带的黏膜白斑,未发现单独存在黏膜红斑的病例。喉部黏膜均伴有非特异性炎症,其中4例声嘶患者声带充血和肿胀,黏膜呈白斑样增生。抗梅毒治疗的预后均较好。结论咽喉部Ⅱ期梅毒病损区域多为扁桃体和软腭为中心的口咽部,但常伴有喉炎,并可加重声带的机械性损伤。病损主要为黏膜白斑,白斑周围伴潮红色充血带,结合病损局部检查(病理活检和渗出物涂片)和梅毒血清实验室检查可以确诊,青霉素为该病治疗的一线用药。
Objective To investigate the identification and diagnosis of throat syphilis. Methods The clinical data of 21 patients with stage Ⅱ syphilis who were diagnosed with throat symptoms and pharyngeal mucosal lesions in our department of Otorhinolaryngology from February 2011 to January 2015 were analyzed retrospectively. The results of fiberopharyngoscopy, Damage location and shape and clinical features. Results The main lesions of the 21 patients were all oropharyngeal parts with tonsils and soft palate as the center, 8 cases involving the base of the tongue and 5 cases with the mucosal damage of the larynx. Mucosal lesions were manifested as leucorrhea with leucorrhea around the leukoplakia, there was no separate case of mucosal erythema. Throat mucosa are associated with nonspecific inflammation, including 4 cases of hoarseness vocal cord hyperemia and swelling, mucosa was white-like hyperplasia. The anti-syphilis treatment is better prognosis. Conclusion Most of the throat syphilitic lesions are mostly oropharyngeal with tonsils and soft palate, but often accompanied by laryngitis and can aggravate the mechanical damage of the vocal cord. Lesions mainly mucosal leukoplakia, white spots around with the tide red congestion zone, combined with local lesions (biopsy and exudate smear) and syphilis serum laboratory tests can be confirmed, penicillin for the treatment of first-line treatment.