肝结核9例诊治体会.doc

肝结核9例诊治体会
周密王其倪正义许俊(武汉市医疗救治中心 430023)
【摘要】目的对肝结核的临床诊断方法及治疗加以探讨。方法回顾性分析1995年1月- 2009年6月间收治并经病理诊断的9例肝结核病例的临床资料。,术前仅2例疑为肝结核。2例行肝切取活检术,4例行肝叶或肝部分切除术,3例行脓肿切开引流,9例患者均获痊愈。结论肝结核少见,其缺乏特征性的临床表现,唯一有效的确诊方法为病理诊断,通过合理的抗结核药物治疗和外科处理可以治愈。
【关键词】结核肝手术
【中图分类号】R525 【文献标识码】B 【文章编号】2095-1752(2013)20-0301-02
Diagnosis and Treatment of Hepatic tuberculosis
【Abstract】 Aims: To explore the clinic treatment of hepatic tuberculosis. Methods: from 1995 to 2009, the clinical characteristics of hepatic tuberculosis in 9 cases proved by histopathology were retrospectively analyzed. Results: The average age of the patients was , only 2 cases were suspected of tuberculosis pre-operatively. 2 cases were diagnosed by liver biopsy, 4 cases were treated with hepatic resection, and incision and drainage of the liver abscess were performed in 3 cases, all the 9 patients were clinically cured. Conclusions: liver tuberculosis is rare, it is difficult to diagnosis, the only precise diagnosis method is pathologic diagnosis, and it can be cured by correct treatments bining anti-tuberculosis drugs and surgery.
【Key words】 Tuberculosis Hepatic Surgery operation
肝结核临床上少见。我院自1995年1月- 2009年6月间收治肝结核9例, 现报告如下。
临床资料
1. 一般情况:本组男8例,女1例。年龄16-45岁,平均27岁。。。3例伴有肺结核(病情已稳定,其中一例有血播型结核病史)。
2. 临床表现:7例均有肝区隐痛,其中5例伴有低热、乏力和体重减轻,2例伴有盗汗。7例有肝肿大,~,质地中等或较硬,其中4例有轻压痛,3例表面扪及结节。另2例无明显的结核临床表现,因CT及B超