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目的:探讨胸腰椎结核的诊断及鉴别诊断,减少误诊率。方法:2004年1月～2007年12月本科收治入院诊治的腰椎结核39例,通过回顾性研究门诊次数,明确诊断的时限,全身中毒症状,早期单纯腰僵痛,腰僵痛合并腿痛,混合感染,早期X-ray特点,CT、MRI特点,诊断性治疗等探索明确诊断的规律。结果:门诊次数超过3次(25/39)64.1%;门诊时限>2月(15/39)38.5%;全身中毒症状(14/39)35.9%;腰僵痛(30/39)76.9%;腰僵痛合并腿痛(29/39)74.4%;混合感染(6/39)15.4%;早期X-ray阴性(36/39)92.3%;CT明确诊断(30/39)76.9%;MRI明确诊断率(36/39)92.3%。结论:目前胸腰椎结核的早期症状不典型,早期诊断及鉴别诊断对于疾病的治疗和预后、医患关系具有重要意义;MRI对于早期诊断脊柱结核具有重要价值。
Objective: To investigate the diagnosis and differential diagnosis of thoracolumbar tuberculosis and reduce the misdiagnosis rate. Methods: From January 2004 to December 2007, 39 cases of lumbar tuberculosis admitted to hospital for treatment were retrospectively studied. The diagnosis time, systemic symptoms, early lumbar osteoarthritis, lumbar arthritis complicated with leg pain, Mixed infection, early X-ray features, CT, MRI features, diagnostic treatment to explore a clear diagnosis of the law. Results: The number of outpatients was more than 3 times (25/39), 64.1%; the outpatient time was> 2 months (15/39), 38.5%; systemic poisoning symptoms (35/39), waist pain (30/39), 76.9% Lumbar pain with leg pain (29/39), 74.4%, mixed infection (6/39), 15.4%, early X-ray negative (36/39), 92.3%, CT, with definite diagnosis (30/39, 76.9% The diagnostic rate (36/39) 92.3%. Conclusion: At present, the early symptoms of thoracolumbar tuberculosis are not typical. The early diagnosis and differential diagnosis are of great significance for the treatment and prognosis of the disease and the relationship between doctors and patients. MRI is of great value in the early diagnosis of spinal tuberculosis.