肠结核的诊断有时颇为困难,必须全面考虑,辨证地分析全身症状(肠外症状与肠道症状),进行细致的检查与鉴别诊断。临床资料 1.症状与体征 (1)全身症状:肠结核病约70%的病人伴发热、盗汗或体重下降。(2)肠外症状:据尸检及外科手术发现,肠结核多伴有其他脏器结核,肺结核约占80%,肝结核占65%,脾结核占60%,腹膜结核占50%,肾结核占30%,肾上腺结核占15%。有的还有淋巴结核和盆腔结核等。(3)肠道症状:包括恶心、腹胀、食欲减退、不规则腹疼、腹泻或便秘,便鲜血或黑便等。(4)体检可发现腹部压疼或肿块等。 2.实验室检查红细胞沉降速度大多加快,粪便有时可查到抗酸杆菌。痰抗酸杆菌阴性而粪便抗酸杆菌阳性者有诊断参考价值。 3.放射线检查包括肺部照片和大、小肠气钡造影等。肠道主要阳性发现为:小肠运动加快、回盲部变形和激惹及钡影残缺,小肠分节及钡剂分布呈雪花状,回肠壁粘膜皱壁紊乱和不规则溃疡以 The diagnosis of intestinal tuberculosis is sometimes quite difficult, we must fully consider the dialectical analysis of systemic symptoms (extraintestinal symptoms and intestinal symptoms), detailed examination and differential diagnosis. Clinical data 1. Symptoms and signs (1) systemic symptoms: About 70% of patients with intestinal tuberculosis fever, night sweats or weight loss. (2) extraintestinal symptoms: According to autopsy and surgical findings, intestinal tuberculosis often accompanied by other organs tuberculosis, tuberculosis accounts for about 80%, liver tuberculosis accounted for 65%, 60% of spleen tuberculosis, peritoneal tuberculosis accounted for 50%, renal tuberculosis 30%, 15% of adrenal tuberculosis. Some also have tuberculosis and tuberculosis. (3) intestinal symptoms: including nausea, bloating, loss of appetite, irregular abdominal pain, diarrhea or constipation, blood or black stools and so on. (4) physical examination can be found in the abdominal pain or lumps and so on. 2. Laboratory tests most of the accelerated rate of erythrocyte sedimentation, stool can sometimes be found in acid-fast bacilli. Negative acid-fast bacilli and acid-fast bacilli stool have diagnostic reference value. Radiography including lung photos and large, small bowel barium imaging. Intestinal major positive findings were: accelerated small intestine movement, ileocecal deformity and irritation and barium shadow incomplete, small intestine section and barium distribution was snow-like, ileal wall mucosal folds disorder and irregular ulcer to