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目的提高对肺结核球的鉴别诊断水平。方法回顾性总结我院1997年1月至2005年12月经临床病理证实且资料完整的56例肺结核球患者的临床资料。结果本组56例肺结核球中直径2~5 cm者54例(96.4%);发生于右肺35例,左肺21例,病灶呈分叶状3例,病灶内空洞12例,病灶周围卫星灶23例,胸膜皱缩征6例,合并肺不张2例;术前误诊为肺癌的18例(32.1%);误诊为肺错构瘤的1例(1.8%)。结论肺结核球病的诊断在重视影像资料的基础上,应结合病史、症状和体征,尤其是结核菌素试验和痰抗酸杆菌检查;还应重视经皮肺穿刺活检术的应用。
Objective To improve the differential diagnosis of tuberculosis ball. Methods The clinical data of 56 patients with pulmonary tuberculosis who were clinically and pathologically confirmed and complete in data from January 1997 to December 2005 in our hospital were retrospectively reviewed. Results In the group of 56 cases with pulmonary tuberculosis, 54 cases (96.4%) had diameter of 2 ~ 5 cm, 35 cases occurred in the right lung, 21 cases in the left lung, 3 lobes in the lesion, 12 lesions in the lesion, Twenty-three cases were diagnosed as stovepipe, 23 cases were diagnosed as pleural shrinkage, 6 cases were pleural shrinkage, and 2 cases were complicated by atelectasis. 18 cases (32.1%) were misdiagnosed as lung cancer before operation and 1 case (1.8%) misdiagnosed as pulmonary hamartoma. Conclusions The diagnosis of tuberculous meningitis should pay attention to the imaging data, based on the history, symptoms and signs, especially the tuberculin test and sputum acid-fast bacilli examination; should pay attention to the application of percutaneous pulmonary biopsy.