摘要
目的通过对食管结核的消化内镜下表现和其他临床资料的分析,提高消化内镜对此病的诊断率。方法回顾分析南昌大学第一附属医院2004年1月～2009年7月确诊的12例食管结核患者,并复习国内文献。结果患者主要临床表现为吞咽困难6例,胸骨后烧灼痛4例,上腹部不适2例,低热盗汗3例。病变位于食管中段10例,下段2例。以溃疡为主要表现者7例,隆起性病变为主要表现者5例。超声内镜6例患者中,4例病变深达肌层,2例全层结构破坏。内镜下行电子染色及卢戈染色2例,均着色。11例经内镜下活检病理确诊,1例手术确诊。结论食管结核好发于中青年,病变部位主要位于食管中下段,电子胃镜下主要表现为隆起型和溃疡型,易误诊为食管癌和黏膜下肿瘤。通过电子胃镜下活检及染色,结合超声内镜能明显提高该病的诊断率。
[Objective] To improve diagnosis on esophageal tuberculosis by digestive system endoscope. [Methods]Twelve cases of esophageal tuberculosis from 2004 to 2009 in our hospital and domestic literature were reviewed.[Results]The median age of the twelve patients （4 male and 8 female cases） was 37 years. The main presenting symptoms were dysphagia （6 cases）, burning pain after sternum （4 cases）, epigastric discomfort （2 cases）, low-grade fever and night sweat （3 cases）. The middle esophagus was involved in 10 cases and lower third of the esophagus were affected in 2 cases. The endoscopic appearances included ulcer （7 cases）, mass lesion （5 cases）. The lesion reach to muscular layer of esophagus （4 cases） and influence full-thickness of esophagus （2 cases） by ultrasonic endoscope. Tow cases was stained by endoscope. The diagnoses were confirmed by biopsies with pathology in 11 cases and by operate in 1 cases.[Conclusion]Esophageal tuberculosis always appear in young and it influences the middle and low part of the esophagus. The commonest abnormalities identified by endoscopy are ulceration and mass lesion. It always confuse esophageal cancer and submucous tumor. Repeated endoscopic examination with biopsies and stain can enhance the diagnosis.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第5期481-484,共4页
China Journal of Endoscopy
关键词
结核
食管
消化内镜
诊断
tuberculosis
esophagus
digestive system endoscopy
diagnosis
