摘要
背景:胰腺结核在临床上较为罕见,其临床症状、影像学表现缺乏特异性,极易与胰腺良恶性肿瘤混淆。目的:总结胰腺结核的临床特点。方法:回顾性分析2010年4月—2019年6月空军军医大学西京消化病医院收治的胰腺结核患者的病史、临床表现、实验室检查、影像学检查、病理资料。结果:本组19例胰腺结核患者中,男性11例,女性8例,中位年龄33岁;临床表现主要为腹痛或上腹不适、发热、盗汗等;实验室检查示11例贫血,红细胞沉降率增快13例,血淀粉酶升高7例,T-spot阳性9例,PPD皮试阳性3例,胆红素升高5例;影像学检查示胰腺结核好发于胰头部,腹部超声示胰腺肿物、内部回声改变8例,胰腺囊性或实性占位11例;CT提示胰头体积明显增大5例,胰腺实性占位7例,胰腺囊性占位4例,伴有胰腺周围淋巴结、肠系膜淋巴结或腹膜后淋巴结肿大6例;8例患者行14次内镜超声引导下细针穿刺活检术,5例行超声引导下经皮胰腺占位穿刺活检。全部患者确诊后给予正规药物抗结核治疗,随访期间无复发。结论:对于年轻的胰腺占位性病变患者,应考虑胰腺结核的可能,组织病理学检查仍是目前确诊的方法,正规抗结核治疗是胰腺结核的主要治疗方法。
Background:Pancreatic tuberculosis is relatively rare in clinical practice,its clinical symptoms and imaging findings are lack of specificity,and is easily confused with pancreatic benign and malignant tumors.Aims:To summarize the clinical characteristics of pancreatic tuberculosis.Methods:Data of 19 patients with pancreatic tuberculosis from April 2010 to June 2019 at Xijing Hospital of Digestive Diseases,Air Force Medical University were retrospectively analyzed.Results:Among the 19 patients with pancreatic tuberculosis,11 were male and 8 were female,median age was 33 years old.Clinical manifestations were mainly abdominal pain or upper abdominal discomfort,fever,night sweat,etc.Laboratory tests showed anemia in 11 patients,increased erythrocyte sedimentation rate in 13 patients,increased amylase in 7 patients,positive T-spot in 9 patients,positive PPD skin test in 3 patients and elevated bilirubin in 5 patients.Imaging examination showed that pancreatic tuberculosis was mainly located in pancreatic head.Ultrasound of the abdomen showed pancreatic mass,changes of internal echo in 8 patients,and pancreatic cystic or solid mass in 11 patients.CT showed significant enlargement of pancreatic head in 5 patients,solid pancreatic occupying lesion in 7 patients,cystic pancreatic occupying lesion in 4 patients,and enlargement of peripancreatic,mesenteric or retroperitoneal lymph nodes in 6 patients.Fourteen endoscopic ultrasound-guided fine-needle aspiration biopsy were performed in 8 patients;5 patients underwent ultrasound-guided percutaneous biopsy of the occupying lesion.All the patients were given regular anti-tuberculosis treatment,and no relapse was found during the follow-up.Conclusions:For young patients with pancreatic space-occupying lesion,the possibility of pancreatic tuberculosis should be considered.Biopsy is still the current method of diagnosis,and regular anti-tuberculosis treatment is the main treatment for pancreatic tuberculosis.
作者
王小娟
梁树辉
刘清
WANG Xiaojuan;LIANG Shuhui;LIU Qing(Department of Gastroenterology, Xi’an Honghui Hospital, Xi’an ,710000;Department of Gastroenterology, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi’an)
出处
《胃肠病学》
2020年第4期226-228,共3页
Chinese Journal of Gastroenterology
基金
国家自然科学基金面上项目(81571731)
陕西省重点研发计划项目(2018SF-161)。
关键词
胰腺结核
诊断
治疗
Pancreatic Tuberculosis
Diagnosis
Therapy
