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我国结核病仍较常见,近年来由于肾上腺皮质激素的广泛应用,不少病人因用激素后致潜在的结核病灶播散,造成严重的粟粒性结核。由于临床症状不典型,且医务人员对结核病的警惕性不高,以致延误诊断而造成严重后果。为了早期发现结核病,对长期使用激素的病人,除了定期作X线检查外,体液及分泌物的抗酸杆菌检查很有帮助。现将我院近年来通过痰、脓液涂片检查抗酸杆菌,以及肝穿刺与纤维支气管镜取活检等确诊的少数结核病例介绍如下: 【例1】徐××,女,19岁,病历号C69541。于1972年6月发现急性淋巴细胞白血病(急淋),开始用强的松、环磷酰胺、长春新硷等治疗。9月并发脑膜白血病再次治疗。1973年至1976年急淋缓解,但强的松一直未间断。1976年4月开始高热,X线胸片示右下肺有片状阴影,左上纵鬲及肺门有肿大淋巴结,考虑肺部感染,用多种抗生素无效,
Tuberculosis is still more common in our country, in recent years due to the widespread use of adrenal cortex hormones, many patients with hormones caused by potential tuberculosis disseminated, resulting in severe miliary tuberculosis. Due to the clinical symptoms are not typical, and medical staff of the vigilance of tuberculosis is not high, resulting in delayed diagnosis and cause serious consequences. In order to detect tuberculosis early, patients with long-term use of hormones, in addition to regular X-ray examination, the body fluids and secretions of acid-fast bacilli helpful. Now in our hospital through sputum, pus smear acid-fast bacilli, and liver biopsy and fiberoptic bronchoscopy and other confirmed cases of a small number of tuberculosis are as follows: [Example 1] Xu × ×, female, 19 years old, medical records No. C69541. In June 1972 found that acute lymphoblastic leukemia (acute lymphoblastic), began with prednisone, cyclophosphamide, vincristine and other treatment. September concurrent treatment of meningocytic leukemia again. Emergency relief from 1973 to 1976, but prednisone has been uninterrupted. High fever began in April 1976, X-ray showed a shadow in the lower right lung, left upper longitudinal folds and hilar lymph nodes, consider the lung infection, with a variety of antibiotics,