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肝与腹腔结核:2016年更新

Hepatic and Intra-abdominal Tuberculosis: 2016 Update.

作者信息

Evans Richard P T, Mourad Moustafa Mabrouk, Dvorkin Lee, Bramhall Simon R

机构信息

Wye Valley NHS Trust, Department of Surgery, The County Hospital, Union Walk, Hereford, HR1 2ER, UK.

North Middlesex University Hospital, London, UK.

出版信息

Curr Infect Dis Rep. 2016 Dec;18(12):45. doi: 10.1007/s11908-016-0546-5.

Abstract

Mycobacterium tuberculosis (TB) infection affects nearly 10 million people a year and causes 1.5 million deaths. TB is common in the immunosuppressed population with 12 % of all new diagnoses occurring in human immune deficiency virus (HIV)-positive patients. Extra-pulmonary TB occurs in 12 % of patients with active TB infection of which 3.5 % is hepatobiliary and 6-38 % is intra-abdominal. Hepatobiliary and intra-abdominal TB can present with a myriad of non-specific symptoms, and therefore, diagnosis requires a high level of suspicion. Accurate and rapid diagnosis requires a multidisciplinary team (MDT) approach using radiology, interventional radiology, surgery and pathology services. Treatment of TB is predominantly medical, yet surgery plays an important role in managing the complications of hepatobiliary and intra-abdominal TB.

摘要

结核分枝杆菌(TB)感染每年影响近1000万人,并导致150万人死亡。结核病在免疫抑制人群中很常见,所有新诊断病例中有12%发生在人类免疫缺陷病毒(HIV)阳性患者中。肺外结核病发生在12%的活动性结核感染患者中,其中3.5%为肝胆结核,6 - 38%为腹腔内结核。肝胆结核和腹腔内结核可表现出多种非特异性症状,因此,诊断需要高度怀疑。准确快速的诊断需要采用多学科团队(MDT)方法,利用放射学、介入放射学、外科和病理学服务。结核病的治疗主要是药物治疗,但手术在处理肝胆结核和腹腔内结核的并发症方面发挥着重要作用。

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