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大肠结核较为少见，临床误诊率高，文章旨在提高诊断正确率及进行合理的治疗。通过对２３例大肠结核病人的诊治过程进行的回顾性分析，发现大肠结核的术前、术后误诊率分别为７８．３％和４５．０％，较易误诊的疾病是恶性肿瘤与克隆病。其中１８例得到随访，平均随访时间９．７年，均被治愈而无复发。认为ＰＣＲ技术检测结核杆菌、内镜细针抽吸细胞学检查将能提高大肠结核的诊断率；全消化道造影有助于与大肠肿瘤的鉴别；与克隆病的鉴别主要依赖于病理学检查及诊断性抗痨治疗；必要时可行剖腹探查术，但术中应常规行快速切片检查。提示：若能术前明确诊断，多数病人能经抗痨治愈，则可避免不必要的手术探查。
Colorectal tuberculosis is relatively rare, clinical misdiagnosis rate, the article aims to improve the diagnostic accuracy and reasonable treatment. According to the retrospective analysis of the diagnosis and treatment of 23 cases of large intestine tuberculosis, the misdiagnosis rates of preoperative and postoperative colorectal tuberculosis were 78.3% and 45.0%, respectively. The misdiagnosed diseases were malignant tumors and Crohn’s disease . 18 cases were followed up, the average follow-up time 9.7 years, were cured without recurrence. PCR detection of Mycobacterium tuberculosis, endoscopic fine needle aspiration cytology can improve the diagnosis of tuberculosis of the large intestine; total digestive angiography contribute to the identification of colorectal cancer; and the identification of Crohn’s disease mainly depends on pathological examination and Diagnostic anti-tuberculosis treatment; if necessary, feasible laparotomy, but intraoperative routine routine biopsy. Tip: If a clear preoperative diagnosis, most patients can be cured by anti-则, you can avoid unnecessary surgical exploration.