摘要
目的探讨喉结核的临床特征和病变形态特点。方法回顾性分析2010年1月至2013年12月就诊于我科的75例喉结核患者的临床资料，包括纤维喉镜、胸部CT和病理活检等诊断资料和治疗方案。结果75例中，男50例，女25例，年龄18～91岁，中位年龄44岁，病程1～19个月，平均病程6.3个月。喉结核的喉部症状主要为声音嘶哑 （59例，79%）和咽喉疼痛（48例，64%），全身症状主要为乏力消瘦（26例，35%）及发热（17例，23%）。75例中原发性喉结核23例（31%），伴有肺结核的继发性喉结核52例（69%）。喉镜下病变部位≤2处者44例，多部位（≥3个部位）受累者31例且均为继发性喉结核。病变部位中声带受累的例数最多（51例，68%），其次是会厌部（41例，55%）。喉部病变的主要表现形态包括增生肿块34例（45%），黏膜肿胀15例（20%），黏膜溃疡26例（35%）。同时存在2种或2种以上病变形态的54例（72%），但往往以一种病变表现形态为主。影像学主要表现为浸润性斑片影和纤维空洞，双肺弥漫分布的大小结节、病灶稳定的结核球以及长期静止的条索或结节影，52例继发性喉结核患者中，肺结核27例，血行播散型肺结核9例，稳定或陈旧性肺结核16例。所有患者均经病理确诊后行系统性抗结核治疗，预后较好。结论 喉结核以喉部症状为主要表现，全身症状不明显。继发性喉结核较原发性喉结核的病变范围广。喉结核的病变表现为肿胀、溃疡和增生，可多种并存，相互转化，但以一种表现为主。最终确诊有赖于病理活检，治疗需要规范的抗结核治疗。
ObjectiveTo investigate the clinical and pathological features of laryngeal tuberculosis. MethodsThe clinical data of 75 patients with laryngeal tuberculosis from Jan 2010 to Jan 2013 in our hospital were studied retrospectively. There were 50 male and 25 female patients, aged from 18 to 91 years, with a median age of 44 years. The course of disease was 1 to 19 months. ResultsThe prominent presenting symptoms were hoarseness （n=59, 79%）, and sore throat （n=48, 64%）. Systemic symptoms included fatigue with weight loss （n=26, 35%） and fever （n=17, 23%）. Primary laryngeal tuberculosis was found in 23 patients （31%） while secondary laryngeal tuberculosis together with pulmonary tuberculosis in 52 patients （69%）. There were 2 or less lesions in the larynx in 44 patients, while multiple lesions were found in 31 patients. Vocal cords were the most common sites affected（n=51, 68%）, followed by epiglottis（n=41, 55%）. Proliferation was the main type of lesions （n=34, 45%）. After pathologic diagnosis, all patients received systemic anti-tuberculosis therapy, and the prognosis was good. ConclusionsSevere local symptoms of the larynx with slightly general symptoms are the clinical characteristics of laryngeal tuberculosis for the time being. Primary laryngeal tuberculosis often present with fewer （2 or less） lesions. Different morphology of laryngeal lesions can exist at the same time. The diagnosis of laryngeal tuberculosis depends on pathological biopsy. The treatment should be systemic anti-tuberculosis therapy.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2016年第8期612-615,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
结核
喉
Tuberculosis
Larynx
