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韩国东南部的腹腔结核病的临床特征和结局:12 年的经验。

Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience.

机构信息

Department of Surgery, Gyeongsang National University Hospital, 15, Jinju-daero 816 beon-gil, Jinju-si, 52727, Gyeongnam, Republic of Korea.

Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 15, Jinju-daero 816 beon-gil, Jinju-si, Gyeongnam, 52727, Republic of Korea.

出版信息

BMC Infect Dis. 2018 Dec 27;18(1):699. doi: 10.1186/s12879-018-3635-2.

Abstract

BACKGROUND

Abdominal tuberculosis (TB) is an uncommon form of infection with Mycobacterium tuberculosis in Korea. In this study, we aimed to highlight the clinical features, diagnostic methods, and outcomes of abdominal TB over 12 years in Southeastern Korea.

METHODS

A total of 139 patients diagnosed as having abdominal TB who received anti-TB medication from January 2005 to June 2016 were reviewed. Among them, 69 patients (49.6%) had luminal TB, 28 (20.1%) had peritoneal TB, 7 (5.0%) had nodal TB, 23 (16.5%) had visceral TB, and 12 (8.6%) had mixed TB.

RESULTS

The most frequent symptoms were abdominal pain (34.5%) and abdominal distension (21.0%). Diagnosis of abdominal TB was confirmed using microbiologic and/or histologic methods in 76 patients (confirmed diagnosis), while the remaining 63 patients were diagnosed based on clinical presentation and radiologic imaging (clinical diagnosis). According to diagnostic method, frequency of clinical diagnosis was highest in patients with luminal (50.7%) or peritoneal (64.3%) TB, while frequency of microscopic diagnosis was highest in patients with visceral TB (68.2%), and frequency of histologic diagnosis was highest in patients with nodal TB (85.2%). Interestingly, most patients, except those with nodal TB, showed a good response to anti-TB agents, with 84.2% showing a complete response. The mortality rate was only 1.4% in the present study.

CONCLUSIONS

Most patients responded very well to anti-TB therapy, and surgery was required in only a minority of cases of suspected abdominal TB.

摘要

背景

在韩国,腹部结核(TB)是一种罕见的由结核分枝杆菌引起的感染形式。本研究旨在强调韩国东南部 12 年来腹部 TB 的临床特征、诊断方法和结局。

方法

回顾了 2005 年 1 月至 2016 年 6 月期间接受抗结核药物治疗的 139 例诊断为腹部 TB 的患者。其中,69 例(49.6%)为腔道 TB,28 例(20.1%)为腹膜 TB,7 例(5.0%)为淋巴结 TB,23 例(16.5%)为内脏 TB,12 例(8.6%)为混合性 TB。

结果

最常见的症状是腹痛(34.5%)和腹胀(21.0%)。76 例患者(确诊诊断)通过微生物学和/或组织学方法确诊为腹部 TB,其余 63 例患者根据临床表现和影像学检查(临床诊断)诊断为腹部 TB。根据诊断方法,腔道(50.7%)或腹膜(64.3%)TB 患者的临床诊断频率最高,而内脏 TB 患者的显微镜诊断频率最高(68.2%),淋巴结 TB 患者的组织学诊断频率最高(85.2%)。有趣的是,除了淋巴结 TB 患者外,大多数患者对抗结核药物反应良好,84.2%的患者完全缓解。本研究中死亡率仅为 1.4%。

结论

大多数患者对抗结核治疗反应良好,仅少数疑似腹部 TB 患者需要手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cb6/6307147/abe9b0a61178/12879_2018_3635_Fig1_HTML.jpg

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