原發性喉結核

喉結核通常是肺結核的合併症，原發性的喉結核並不常見。本文提出7例胸部X光檢查正常之喉結核病例，其臨床症狀主要是聲音嘶啞，間接喉鏡檢查則以肉芽狀組織形態侵犯聲帶較多。7名病患都經婁部切片檢查，由組織病理加以證實，並接受抗結核藥物治療。結果其中6例療效良好，但例7卻因併發播散性結核而死亡。在病患家屬的追蹤裡，發覺例1的2個小孩亦感染肺結核，經一併治療後皆已康復。茲將此經驗提出報告，並強調：1.在聲音嘶啞的病患中，若喉部有肉芽組織，即使其胸部X光檢查正常，仍須作切片檢查以排除喉結核的可能性。2.原發性喉結核的療效一般良好，但若延誤治療仍可能造成死亡。3.原發性喉結核仍具傳染性，病患須接受隔離治療。

關鍵字

喉結核；原發性的

並列摘要

Laryngeal tuberculosis as a complication of pulmonary tuberculosis is not uncommon. However, primary laryngeal tuberculosis is very rare. Here, We present seven cases of laryngeal tuberculosis with normal chest X-ray. The prominent presenting symptom-hoarseness was noted in six patients. Indirect laryngoscopy was performed on all patients. Distinguished finding of this examination was granulation on vocal folds. After revealing typical pictures of tuberculosis from histopathology, via laryngeal biopsy, all patients received antituberculous chemotherapy. Except one of the patients died of disseminated tuberculosis, rest of the cases all responded satisfactorily to chemotherapy. With the seven cases’ experiences, we make three conclusions. 1. Laryngeal biopsy is mandatory in patients with granulation in larynx to exclude the possibility of laryngeal tuberculosis, in spite of a normal chest X-ray examination. 2. The outcome of antituberculosis chemotherapy in patient with primary laryngeal tuberculosis is usually effective. Yet, it may be fatal, if appropriate treatment is not provided. 3. The infectivity of primary laryngeal tuberculosis is considered to be a potential threat. Therefore, patients should be treated isolatedly to avoid spreading.

並列關鍵字

laryngeal tuberculosis ； primary

國際替代計量

原發性喉結核

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