摘要
目的探讨腱鞘结核的误诊原因及减少误诊发生的对策。方法回顾性分析1991年1月至2003年12月收治的15例腱鞘结核患者诊治过程,总结分析其临床特点及误诊原因。结果本组病例发病到确诊时间为2～36个月,平均为(16±10)个月;其中12例术前误诊。病例均采用手术切除并全身化疗的治疗方式,除1例术后2个月失访外,其余病例随访2.5～7.0年,平均4.6年,未见复发或身体其他地方出现结核灶。失访1例为红斑狼疮应用免疫抑制剂治疗的患者,术后1个月发现病变对侧腕、踝关节结核。结论缺乏典型临床表现、过分依赖实验室检查是延误早期确诊的重要原因;应对可疑病例进行常规结核排查,穿刺抽液进行病原学检查,术中病理检查有利于确诊。
Objective To investigate the factors for misdiagnosis of tuberculosis in synovial sheath, and therefore to improve the early diagnosis of the disease. Methods From January 1991 to December 2003, 15 cases of tuberculosis in the synovial sheath were treated using surgery and anti-tuberculous agents. The clinical features and the related factors for misdiagnosis were analyzed. Results The duration from onset of symptom and sign to a final diagnosis was （ 16 ± 10） months （ range from 2 to 36 months）. Twelve cases were misdiagnosed before surgery. All cases were followed up for 2. 5 to 7 years without recurrence, except one case of systemic lupus erythematosus complicated with tuberculosis of the wrist and the ankle 1 month after operation. Conclusion Lack of specific symptoms and signs, nonspecific radiological manifestations and over-dependence on laboratory examinations were the major factors responsible for early misdiagnosis.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2007年第2期121-123,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
结核
腱鞘
误诊
Tuberculosis
Synovial sheath
Diagnostic errors
