论文部分内容阅读
目的总结空洞性肺结核的临床和影像学特点,以提高诊断水平,减少误诊。方法对2004年至2010年临床病理证实的空洞性肺结核误诊患者的临床与影像学资料进行回顾性分析。结果 57例空洞性肺结核患者中误诊为肺脓肿空洞43例、肺癌空洞10例、肺囊肿4例。确诊病例中经痰涂片找到抗酸杆菌者32例,经纤维支气管镜检查及病理活检确诊8例,手术病理活检确诊1例,经2周以上抗感染治疗无效试验性抗结核化疗疗效显著而确诊16例。所有患者经过正规系统的抗结核治疗均预后良好。结论空洞性肺结核患者临床与影像学表现不典型,在临床工作中应不断总结经验,提高鉴别诊断水平,配合必要的辅助检查减少误诊率。
Objective To summarize the clinical and imaging features of pulmonary tuberculosis in order to improve the diagnostic level and reduce the misdiagnosis. Methods The clinical and imaging data of patients with clinically pathologically confirmed pulmonary tuberculosis who were misdiagnosed from 2004 to 2010 were analyzed retrospectively. Results 57 cases of empty tuberculosis were misdiagnosed as lung abscess cavity in 43 cases, lung empty hole in 10 cases, 4 cases of pulmonary cysts. Among the confirmed cases, 32 cases of acid-fast bacilli were found by sputum smear, 8 cases were diagnosed by fiberoptic bronchoscopy and pathological biopsy, 1 case was diagnosed by biopsy and more than 2 weeks after anti-infective treatment, the curative effect of experimental anti-tuberculosis chemotherapy was significant 16 cases diagnosed. All patients underwent formal systemic antituberculosis treatment with a good prognosis. Conclusion The clinical manifestations of the patients with pulmonary tuberculosis are not typical. Clinical experience should be summarized to improve the differential diagnosis and to reduce the misdiagnosis rate with necessary auxiliary examination.