5O例鼻咽结核的诊治分析.pdfVIP

临床耳鼻咽喉头颈外科杂志 2012正 JClinOtorhinolaryng01HeadNeckSurg(China) 26卷 24期 · 研 究 手艮告 · 5O例鼻咽结核的诊治分析 简奕娈 刘宝瑛 郭丽霞 孔少颜 苏肖敏 卢春丽 [摘要] 目的：分析鼻咽结核的临床表现及诊疗特点，为提高鼻咽结核的临床诊断率提供科学依据。方法： 回顾性分析在广州市胸科医院就诊并确诊为鼻咽结核的5O例患者的临床资料。5O例患者均采用 3HRZS(E)／ 9HR(E)方案抗结核治疗 1年，局部用异烟肼、利福平、链霉素的针剂联合喷鼻 3个月。结果：全部患者治疗期间 没有出现耐药现象，全部完成 1年的疗程后治愈并在停药后随访 2年均无复发。结论：鼻咽结核较少见，临床表 现不典型，极易误诊，充分了解发病的成因及发病初期鼻咽镜下的临床表现及特点，并及时做活检组织病理检查 是诊断的关键 ，从而 明确诊断并给予正规 的抗结核治疗 。 [关键词] 结核；鼻咽 ；诊断；治疗 [中图分类号] R766．3 [文献标志码] A [文章编号] 1001—1781(2012)24—1138—03 PathogenyandtreatmentOf50nas0pharyngealtuberculosiscases JIAN Yiluan L儿 Baoying GUOLixia K0NGShaoyan SUXiaomin LL，Chunli (DepartmentofOtolaryngology，GuangzhouChestHospital，Guangzhou，510095，China) Correspondingauthor：jIAN Yiluan，E—mail：CHYANG1(scut．edu．cn Abstract 0bjective：Toanalyzetheclinicalcharactersandtreatmentofnasopharyngealtuberculosis，andto provideascientificbasisforimprovingclinicaldiagnosisofnasopharyngea1tuberculosis．Method：Theclinicalma— terialsof50patientsdiagnosedasnasopharyngealtuberculosisinGuangzhouChestHospitalwerereviewedandan— alyzed．Allthe50patientsweregivenregularantituberculosistreatmentwith3HRZS(E)／9HR(E)foroneyear， andweretreatedthroughnasalspraywithcombinationmedicationofisoniazid，rifampicinandstreptomycininjec— tionsolutionfor3months．Result：Allpatientswerecuredthroughregularantituberculosistreatmentforoneyear， andnorecrudescencecaseswerefoundin2yearsoffollow-up．Conclusion：Nasopharyngealtuberculosisisrareand theclinicalmanifestationisatypica1．ItisextremelyeasytOcauseclinicalmisdiagnosis．A fullunderstandingofthe pathogenesis，timelyclinicalcharactersundernasopharyngoscopeandhistopatho1ogicalexaminationresultsarethe keystodiagnosis，andtOgivingregularantituberculosistre