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目的探讨肠结核诊断及内、外科治疗方法。方法回顾性病例分析及文献综述。结果我院１９８３～１９９７年共收治３７例肠结核病例，其中２６例行钡餐阳性率１００％（２６／２６）、钡灌肠２４例阳性率１００％（２４／２４）和纤维结肠镜１７例阳性率９４１％（１６／１７）。单纯内科治疗２１例，１６例因并发症或误诊接受外科治疗，１３例切除病变肠管，３例行开腹活检或穿孔修补术。内科治疗组，抗结核时间２０个月，复发４例；切除病变肠管的１３例患者平均抗结核时间１０个月，没有复发；行开腹活检或穿孔修补的３例患者抗结核时间１９个月，１例复发。结论钡餐、钡灌肠、纤维结肠镜是较为有效的检查方法，对于伴有腹部并发症的患者及早积极采用外科手术治疗切除病变肠管及术后抗结核治疗，从治疗时间、治疗复发等方面可能优于单纯内科保守治疗。
Objective To investigate the diagnosis and treatment of intestinal tuberculosis. Methods retrospective case analysis and literature review. Results A total of 37 cases of enteric tuberculosis were treated in our hospital from 1983 to 1997. Of the 26 cases, the positive rate of barium meal was 100% (26/26), the positive rate of barium enema was 100% (24/24) and fibro-colonoscopy was positive Rate 94 1% (16/17). Simple medical treatment in 21 cases, 16 cases of surgical complications due to complications or misdiagnosis, 13 cases of diseased bowel, 3 cases of open biopsy or perforation repair. In the medical treatment group, the anti-tuberculosis time was 20 months and the recurrence occurred in 4 cases. Thirteen patients with diseased intestinal tract had an average anti-TB time of 10 months without recurrence. The three patients who underwent laparotomy or perforation were anti-TB for 19 months , 1 case of recurrence. Conclusions Barium meal, barium enema and colonoscopy are more effective methods for early congenital abdominal complications in patients with aggressive surgical resection of bowel and postoperative anti-TB treatment, from the treatment time, the treatment of relapse may be superior In simple medical conservative treatment.