摘要
目的探讨伴腹腔积液及癌抗原(CA)125升高女性盆腔结核的临床特点、诊治方法及误诊原因、防范措施。方法对误诊为卵巢癌的伴腹腔积液及CA125升高女性盆腔结核2例的临床资料进行回顾性分析。结果本组2例均因腹胀及食欲不振等消化系统症状就诊,皆伴腹腔积液及CA125升高,就诊初期均考虑卵巢癌,皆行腹腔镜探查术,最终结合临床表现及术后病理检查等明确盆腔结核诊断,给予规范抗结核治疗21和70 d后病情好转。现2例均规范抗结核治疗中。结论女性盆腔结核无特异性临床表现,尤其是伴腹腔积液及CA125升高者极易误诊为卵巢癌。提高对本病认识和警惕性、及时进行相关医技检查,临床接诊类似本文诊断困难患者必要时可行腹腔镜探查术或剖腹探查术,以减少或避免女性盆腔结核误诊误治。
Objective To summarize clinical characteristics, diagnosis and treatment methods, causes of misdiagnosis and preventive measures of.female pelvic tuberculosis with ascites and elevated cancer antigen(CA)125. Methods The clinical data of 2 cases of pelvic tuberculosis with ascites and elevated CA125 misdiagnosed as ovarian malignancy was analyzed retrospectively. Results The two patients in this study were all hospitalized due to gastrointestinal symptoms, including abdominal distention and poor appetite accompanied with ascites and elevated CA125. Ovarian malignancy was initially considered and laparoscopic exploration was performed in both cases. Finally, the diagnosis of pelvic tuberculosis was made by combining clinical manifestations and postoperative pathological examination, and the condition was improved after regular anti-tuberculosis treatment for 21 and 70 d respectively. At present, the two patients are all under standard anti-tuberculosis treatment. Conclusion Given lack of specific clinical manifestation, pelvic tuberculosis in women, especially in those with ascites and elevated CA125, is easily misdiagnosed as ovarian malignancy. Clinicians should improve their awareness and vigilance of the disease, and carry out relevant examinations in a timely manner. In case of difficult diagnosis similar to those in this study, laparoscopic or laparotomy exploration can be performed when necessary to reduce or avoid misdiagnosis and mistreatment of pelvic tuberculosis in women.
作者
苏雅琴
董晓瑜
SU Ya-qin;DONG Xiao-yu(Department of Reproductive Medicine,Shijiazhuang First Hospital,Shijiazhuang 050011,China)
出处
《临床误诊误治》
2020年第5期4-7,共4页
Clinical Misdiagnosis & Mistherapy
关键词
结核
盆腔
腹腔积液
癌抗原125
误诊
卵巢肿瘤
Tuberculosis,pelvic
Ascites
Cancer antigens 125
Misdiagnosis
Ovarian neoplasms
