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目的探讨腹腔脏器结核的临床特点、诊治方法,以提高对腹腔脏器结核的诊断水平。方法回顾性分析1958年1月-2004年12月间在北京协和医院收治并经病理诊断的57例腹腔脏器结核病例的临床资料。结果肝结核39例,脾结核5例,胰腺结核8例,胃结核3例,肝结核并胃结核1例,肝结核并脾结核1例。男性26例,女性31例,年龄17～68岁。41例(71.9%)患者并存腹腔以外脏器结核或既往有结核病史。主要临床表现有发热(75.4%),结核中毒症状(82.5%),肝脾肿大(57.9%)。多数患者(59.6%)有血沉增快,肝、脾或胰腺占位病变者占64.9%。结论不明原因长期发热伴有肝脾肿大、血沉增快、影像学提示有腹腔脏器占位病变的病例应警惕结核可能,穿刺取活组织病理检查有助诊断,必要时需剖腹探查,及早抗结核治疗预后良好。
Objective To investigate the clinical features, diagnosis and treatment of abdominal visceral tuberculosis in order to improve the diagnosis of abdominal visceral tuberculosis. Methods The clinical data of 57 cases of tuberculosis of the abdominal cavity treated in Beijing Union Hospital from January 1958 to December 2004 were analyzed retrospectively. Results 39 cases of hepatic tuberculosis, 5 cases of splenic tuberculosis, 8 cases of pancreas tuberculosis, 3 cases of stomach tuberculosis, liver tuberculosis and gastric tuberculosis in 1 case, liver tuberculosis and spleen tuberculosis in 1 case. 26 males and 31 females, aged 17 to 68 years. Forty-one patients (71.9%) had concurrent abdominal tuberculosis or past history of tuberculosis. The main clinical manifestations were fever (75.4%), tuberculosis poisoning symptoms (82.5%), hepatosplenomegaly (57.9%). Most patients (59.6%) had ESR, liver, spleen or pancreatic lesions accounted for 64.9%. Conclusion unexplained long-term fever accompanied by hepatosplenomegaly, ESR, imaging tips of patients with abdominal lesions should be alert to possible tuberculosis, biopsy tissue biopsy can help diagnose, if necessary, laparotomy, as early as possible The anti-TB treatment has a good prognosis.