摘要
目的探究新生儿先天性结核病的临床及影像学特点,分析致死原因,以提高该病的早期诊断准确性。方法回顾性分析我院2例先天性结核病新生儿的临床特点及影像学表现,并进行相关文献复习。结果2例患儿的胸部X线片及计算机断层扫描(CT)表现为双肺内弥漫分布结节样高密度影,部分结节可见融合,部分结节周围伴少许渗出;腹部CT提示肝脏及脾脏内出现多发低密度结节影;腹部X线片示部分肠管积气扩张并多发宽大气液平面,提示肠梗阻伴腹水;复查腹部X线片诊断为肠穿孔伴液气腹形成。2例患儿经胃液检查确诊为先天性结核病,最终因十二指肠穿孔、肠穿孔死亡。结论先天性结核病的临床表现不典型,影像学表现为双肺广泛播散病灶,肝脏内多发结节。临床发现上述影像学表现时需考虑本病,且可结合结核生化指标检测进行诊断。此类患儿并发脑膜炎、肠梗阻时可能提示预后不良。
Objective To explore the clinical and imaging characteristics of neonatal congenital tuberculosis,and analyze the lethal causes,so as to improve the early diagnosis accuracy of the disease.Methods The clinical features and imaging findings of 2 neonates with congenital tuberculosis in our hospital were retrospectively analyzed,and related literatures were reviewed.Results The chest X-ray and computer tomography(CT)findings of 2 cases showed diffuse nodular high density shadow in both lungs,some nodules were fused,and some nodules were surrounded by a little exudation;abdominal CT showed there were multiple low-density nodules shadow in the liver and spleen;abdominal X-ray showed partial intestines had gas accumulation,dilatation and wide air-liquid level,suggesting intestinal obstruction with ascites;abdominal X-ray re-examination was diagnosed as intestinal perforation with hydropneumoperitoneum.Two newborns were diagnosed as congenital tuberculosis by gastric juice examination,and died of duodenal perforation and intestinal perforation.Conclusion The clinical manifestations of congenital tuberculosis are not typical,while the imaging findings are extensive disseminated lesions in both lungs and multiple nodules in the liver.The disease should be considered when the above imaging findings are clinically found,and the diagnosis can be made by combining the detection of tuberculosis biochemical indexes.Such newborns with meningitis and intestinal obstruction may indicate poor prognosis.
作者
黄竹媛
张静
HUANG Zhuyuan;ZHANG Jing(Medical Imaging Center,Northwest Women's and Children's Hospital,Xi'an 710061,China)
出处
《临床医学研究与实践》
2022年第21期5-7,共3页
Clinical Research and Practice
