摘要
目的:探讨现代喉结核的临床特征及诊断要点。方法:回顾性分析近8年在我科喉镜室经病理确诊的33例喉结核患者的临床资料。结果:喉结核的主要症状为声嘶喉痛,多数不伴有肺结核(63.6%)。低热、盗汗、消瘦全身症状少见(24.2%)。喉镜检查总结为3种类型:水肿型,增生型和溃疡渗出型。结核菌素纯化蛋白(PPD)检查阳性率87.9%,痰菌检查阳性率68.4%。病理切片可见间质吞噬细胞及巨细胞反应,类上皮细胞和朗汉斯巨细胞增生构成肉芽肿,与坏死组织并存,干酪样坏死灶是其典型表现。结论:现代喉结核的临床特征是喉局部症状严重而全身症状轻,诊断上主要依靠详细的病史、喉镜所见和PPD痰菌检查联合使用,最后确诊尚需病理活检和结核杆菌培养。
Objective： To explore the clinical characteristic and diagnosis of modern laryngeal tuberculosis. Method：A retrospective research among 33 patients of laryngeal tuberculosis, with definitive pathological result, had been done in the laryngeal-endoscope room in our department. Result.. The main symptoms of laryngeal tuber- culosis are hoarseness and sore throat. Most of the patients did not accompany with pulmonary tuberculosis （TB） （63.6%） . Few of them accompany with low-grade fever, night sweat and malnutrition（24.2 %）. There are three types in the laryngeal-endoscope vision., edema type,hyperplasy type and ulcer exudation type. The positive rates of PPD and phlegm bacteria examination are respectively 87.9% and 68.4%. There can be seen in the pathological slides the interstitial phagocytes and giant cell reaction. Granuloma consisting of epithelioid cell and Langhans＇ cells is coexistent with necrotic tissue. Cheesy necrosis is the typical characteristic of the disease. Conclusion： Severe local symptoms of laryngeal with slightly general symptoms are the clinical characteristics of modern laryngeal tuber-culosis. The diagnosis of it depends mainly on the process of the disease, laryngeal-endoscope examination and PPD examination combined with phlegm bacteria examination. And the final diagnosis is based on the pathological biopsy and tubercular bacillus culturing.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2009年第6期261-263,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
喉结核
肺结核
PPD
laryngeal tuberculosis
pulmonary tuberculosis
PPD
