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目的分析肝结核的临床特点,减少误诊和漏诊。方法回顾性总结我院1965年至2008年12月期间主要或全部临床表现为肝结核患者的病史,临床表现,实验室、影象学、肝脏病理检查及治疗转归。结果肝结核患者的临床表现及各项辅助检查结果呈现不一致性,但仍有其相对特征性表现:多有结核病史,大部分有发热,肝脏肿大伴触痛,AKP,γ-GT增高较明显,肝脏病检分别或同时示内芽肿病变、结核样结节或干酪样坏死,常规抗生素治疗效果不好,抗结核治疗有效。结论肝结核临床表现复杂多样,其诊断需要综合分析,没有一项检查能够绝对排除或者诊断结核,疑似患者尽量进行肝脏病理检查。
Objective To analyze the clinical features of liver tuberculosis and reduce misdiagnosis and missed diagnosis. Methods The clinical history, clinical manifestations, laboratory, imaging, liver pathology examination and treatment outcome of major or all clinical manifestations in our hospital from 1965 to December 2008 were retrospectively reviewed. Results The clinical manifestations of liver tuberculosis patients and the results of the auxiliary examination showed inconsistencies, but there are still some of the relative characteristics of the performance: more history of tuberculosis, most of the fever, enlargement of the liver with tenderness, AKP, γ-GT increased significantly , Liver disease, respectively, or at the same time showed intramajority of lesions, tuberculous nodules or caseous necrosis, the effect of conventional antibiotics is not good, anti-TB treatment is effective. Conclusion The clinical manifestations of hepatic tuberculosis are complex and diverse, and its diagnosis needs a comprehensive analysis. None of the tests can absolutely exclude or diagnose tuberculosis, and the suspected patients try their best to carry out liver pathological examination.