食管结核4例并文献复习

Diagnosis and treatment of 4 esophageal tuberculosis patients: analysis and literature review

摘要:

目的 通过探讨食管结核临床特点、消化内镜下表现及诊治经过，提高该病的诊断率。 方法 回顾性分析该科2009年～2012年收治的4例食管结核患者，复习国内外文献。 结果 表现为吞咽疼痛2例，哽咽感2例，伴有盗汗症状1例，4例均为隆起型病变，2例表面合并溃疡，3例反复内镜下活检确诊，1例EMR活检确诊，均予以抗结核治疗12个月，全部缓解治愈，随访10个月～3年，均无吞咽困难或结核病灶复发。 结论 食管结核临床主要表现为吞咽不适。注重病史，联合辅助检查，特别是消化内镜检查结果，有助于诊断。抗结核治疗可取得良好的效果。

Abstract:

【Objective】 To explore the clinical features of esophageal tuberculosis, endoscopic performance, the way of diagnosis and treatment; to improve the diagnosis rate of the disease. 【Methods】 A retrospective analysis of 4 cases of esophageal tuberculosis patients who were treated in our department from 2009 to 2012 and literature reviewed. 【Results】 4 cases, 2 of them presented swallowing pain, 2 cases had swallowing choked feelings, one case accompanied with symptoms of night sweats; All cases showed protruded lesions by endoscopic, 2 combined with ulcer, 3 cases have been confirmed by repeated biopsy, one has been confirmed by the resection specimen through endoscopic minimally invasive surgery. All of them have been treated with anti-TB therapy for 12 months, and were mitigated and completely cured; and 10 months to 3 year’s follow-up afterwards revealed no dysphagia symptom or recurrence of tuberculosis. 【Conclusion】 Dysphagia is the major clinical symptom of esophageal tuberculosis. The focus of medical history, joint laboratory examinations, especially gastrointestinal endoscopy results and biopsy outcome are all helpful to the diagnosis, and anti-TB treatment has good effect as well.