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目的探讨喉结核的临床特征,以提高临床医师对喉结核的认识。方法回顾分析63例喉结核病例的临床资料。声嘶是喉结核患者的主要临床症状,占73.02%,全身症状不明显。所有患者经胸部X线片检查,痰中找抗酸杆菌及组织病理学检查确诊后,送结核病医院治疗。随访6～36个月。结果所有病例中,胸部X线片发现活动性肺结核14例;病理检查证实为陈旧性肺结核36例,13例正常。痰中找到抗酸杆菌1例。所有病例经病理检查主要表现均为肉芽性病变,声带病变累及者多于其他部位段累及者(χ2=21.38,P<0.01)。初诊误诊44例,误诊率为69.84%。结论喉结核的发病率有所增高,在临床工作中应该提高对本病的认识,以减少误诊。
Objective To explore the clinical features of laryngeal tuberculosis to enhance clinicians’ understanding of laryngeal tuberculosis. Methods Retrospective analysis of 63 cases of laryngeal tuberculosis clinical data. Hoarseness is the main clinical symptoms of throat tuberculosis, accounting for 73.02%, systemic symptoms are not obvious. All patients were diagnosed by chest radiography, sputum to find acid-fast bacilli and histopathological examination, sent to hospital for tuberculosis treatment. Follow-up 6 to 36 months. Results In all the cases, 14 cases of active pulmonary tuberculosis were found on chest X-ray. 36 cases of old tuberculosis were confirmed by pathology, and 13 cases were normal. Acid bacilli found in sputum in 1 case. All the cases were characterized by pathological examination of granulomatous lesions, vocal cord lesions involving more than other segments involved (χ2 = 21.38, P <0.01). 44 cases were misdiagnosed, the rate of misdiagnosis was 69.84%. Conclusion The incidence of laryngeal tuberculosis has increased, in clinical practice should raise awareness of the disease in order to reduce misdiagnosis.