不典型肺结核的临床诊断要点分析

发布时间：2018-03-14 04:15

本文选题：不典型肺结核　切入点：诊断要点　出处：《中国实用医药》2016年33期 　论文类型：期刊论文

【摘要】：目的分析不典型肺结核的临床诊断要点。方法回顾性分析128例不典型肺结核患者的临床资料及诊断方法。结果所有患者肺叶、段均可受累,累及两叶以上者有90例。位于肺结核好发部位下叶基底段的患者为60例,位于肺门及纵隔的患者为14例,位于中叶及舌叶的患者为44例,位于上叶尖后段及下叶背段的患者为36例,位于上叶前段的患者为42例。128例患者中结节或肿块型40例,弥漫型12例,肺实变型32例,肺不张型20例,肺门及纵隔淋巴结肿大型14例,肺纹理增多增粗型10例。结论在临床诊疗中,由于不典型肺结核的发生部位、临床表现、CT影像均布具有典型性,需全面、细致地分析患者的胸部CT等临床资料,早期反复性痰涂片试验,积极选择肺穿刺检查与纤支镜检查。若上述方法还无法进行确诊,可实施诊断性抗结核治疗或手术探查方法。
[Abstract]:Objective to analyze the main points of clinical diagnosis of atypical pulmonary tuberculosis. Methods the clinical data and diagnostic methods of 128 patients with atypical pulmonary tuberculosis were retrospectively analyzed. There were 90 cases involving more than two lobes, 60 cases in the basal segment of the lower lobe, 14 cases in the hilum and mediastinum, 44 cases in the middle lobe and the lingual lobe. 36 cases were located in the posterior segment of the upper apex and dorsal segment of the lower lobe, 42 cases were located in the anterior segment of the upper lobe, 40 cases were nodular or mass type, 12 cases were diffuse type, 32 cases were pulmonary consolidation type, and 20 cases were atelectasis type. There were 14 cases of hilar and mediastinal lymphadenopathy and 10 cases of enlarged and thickened lung texture. Conclusion in clinical diagnosis and treatment, because of the location of atypical pulmonary tuberculosis, the clinical manifestations of CT images are all typical and need to be comprehensive. The chest CT and other clinical data of the patients were carefully analyzed, the early repeated sputum smear test was performed, and the pulmonary puncture examination and fiberoptic bronchoscopy were actively selected. If the above methods could not be confirmed, the diagnostic anti-tuberculosis treatment or surgical exploration could be carried out.
【作者单位】：辽宁省锦州市疾病预防控制中心门诊部;
【分类号】：R521

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