CAJ | 학술논문

目的：总结肝结核诊断及治疗体会。方法回顾性分析2000年1月～2012年1月本院收治的5例病理证实为肝结核患者的病例资料，对其临床表现、诊断、治疗及预后进行总结。结果肝结核并发于肺结核或肠道结核较多。2例患者伴肺结核，1例伴发肠结核，1例为肝原发性结核瘤，1例为肾移植术后。肝结核临床症状不典型，多以低热、右上腹痛为临床表现，影像学诊断不明确。针吸活检可证实，其中4例患者行针吸活检证实为肝结核。另外，1例术前诊断为原发性肝癌，术中冰冻及术后病理均证实为肝结核。结论肝结核临床表现不典型，B超引导下穿刺活检为最好的诊断方法；抗结核治疗有效，有手术指征者可行手术治疗。
목적：총결간결핵진단급치료체회。방법회고성분석2000년1월～2012년1월본원수치적5례병리증실위간결핵환자적병례자료，대기림상표현、진단、치료급예후진행총결。결과간결핵병발우폐결핵혹장도결핵교다。2례환자반폐결핵，1례반발장결핵，1례위간원발성결핵류，1례위신이식술후。간결핵림상증상불전형，다이저열、우상복통위림상표현，영상학진단불명학。침흡활검가증실，기중4례환자행침흡활검증실위간결핵。령외，1례술전진단위원발성간암，술중빙동급술후병리균증실위간결핵。결론간결핵림상표현불전형，B초인도하천자활검위최호적진단방법；항결핵치료유효，유수술지정자가행수술치료。
Objective HePatic tuberculosis is uncommon,lack of sPecific clinical manifestations and imaging features,so it can eas-ily be misdiagnosed in clinical.Herein,we discuss variety of its forms and summarize the diagnosis and treatment of hePatic tuberculosis. Methods Five cases of hePatic tuberculosis are described.The diagnosis,treatment and outcome of the Patients are discussed.Results Im-age examination associated with image-guided fine needle asPiration bioPsy is the best diagnostic method.In our center,four Patients under-went needle bioPsy and confirmed hePatic tuberculosis.In addition,one Patient PreoPerative misdiagnosed as Primary carcinoma of liver was confirmed hePatic tuberculosis by intraoPerative bioPsy and PostoPerative Pathology.Three Patients underwent surgical Procedures along with anti-tubercular drug theraPy,two Patients received only anti-tubercular drug theraPy.The renal Post-transPlantation Patient with hePatic tuberculosis eventually died of multiPle organ failure (MODS).The other four Patients were followed for 4~10 years,yielding no recurrence of hePatic tuberculosis.Conclusions:HePatic tuberculosis usually associated with atyPical clinical manifestations.Image examination associated with image-guided fine needle asPiration bioPsy is the best diagnostic method.Anti-TB treatment is effective in most of cases.However,if there are indications for surgery or difficult to diagnose,surgical Procedures along with anti-tubercular drug theraPy could be adoPted.