Abstract：
OBJECTIVE: To investigate the clinical characteristics, diagnosis and prognosis of patients with laryngeal tuberculosis (LTB) combined with respiratory tuberculosis.
METHODS: A retrospective analysis was conducted on 134 patients who underwent endoscopy and were eventually diagnosed with LTB. The patients\' demographic characteristics, clinical manifestations, endoscopic features, auxiliary examination, imaging examination and prognostic characteristics were analyzed.
RESULTS: LTB patients had a median age of 45.5 years (range from 12 to 87 years) and a median course of 3.0 months (range from 0.1 to 72 months). The patients\' symptoms mainly presented as hoarseness (97.0 %), abnormal sensation of pharyngeal (49.3 %), cough and sputum (41.0 %), pharyngalgia (39.6 %), dysphagia (10.4 %) and dyspnea (8.2 %). The positive rate of tuberculous symptoms was 25.4 %. Endoscopic features showed that the lesions mainly involved the glottis (87.3 %), presenting as unilateral lesions (66.7 %), near-full-length involvement (88.0 %), with mucosal waves significantly reduced (86.3 %), followed by supraglottis (43.3 %), subglottis (24.6 %) and the pharynx (15.7 %). The lesions may present as granulomatous proliferation (66.4 %), ulceration (65.7 %) or swelling and exudation (51.5 %). A total of 75 patients (56.0 %) were finally diagnosed with combined pulmonary tuberculosis (PTB), with a positive chest X-ray rate of 25.6 % and a positive chest CT rate of 71.2 %. A total of 42 patients who received anti-tuberculosis treatment were followed up, and 73.8 % of patients had significant improvement in symptoms. The morphology of the pharyngeal and laryngeal mucosa returned to basically normal (59.4 %) or scar-like (34.4 %).
CONCLUSIONS: LTB is usually found in middle-aged men, and patients\' symptoms are mainly hoarseness, abnormal sensation of pharyngeal, pharyngalgia, cough and sputum, and can be combined with tuberculous symptoms. These lesions mainly involve multiple subregions, mainly in the glottis, and can be combined with pharyngeal involvement. There were various types of lesions. Half of the patients were complicated with PTB, and chest CT was superior to X-ray in the detection of pulmonary lesions. After regular anti-tuberculosis treatment, the symptoms and morphology of the pharyngeal and laryngeal mucosa of most patients were significantly improved.
METHODS: A retrospective analysis was conducted on 134 patients who underwent endoscopy and were eventually diagnosed with LTB. The patients\' demographic characteristics, clinical manifestations, endoscopic features, auxiliary examination, imaging examination and prognostic characteristics were analyzed.
RESULTS: LTB patients had a median age of 45.5 years (range from 12 to 87 years) and a median course of 3.0 months (range from 0.1 to 72 months). The patients\' symptoms mainly presented as hoarseness (97.0 %), abnormal sensation of pharyngeal (49.3 %), cough and sputum (41.0 %), pharyngalgia (39.6 %), dysphagia (10.4 %) and dyspnea (8.2 %). The positive rate of tuberculous symptoms was 25.4 %. Endoscopic features showed that the lesions mainly involved the glottis (87.3 %), presenting as unilateral lesions (66.7 %), near-full-length involvement (88.0 %), with mucosal waves significantly reduced (86.3 %), followed by supraglottis (43.3 %), subglottis (24.6 %) and the pharynx (15.7 %). The lesions may present as granulomatous proliferation (66.4 %), ulceration (65.7 %) or swelling and exudation (51.5 %). A total of 75 patients (56.0 %) were finally diagnosed with combined pulmonary tuberculosis (PTB), with a positive chest X-ray rate of 25.6 % and a positive chest CT rate of 71.2 %. A total of 42 patients who received anti-tuberculosis treatment were followed up, and 73.8 % of patients had significant improvement in symptoms. The morphology of the pharyngeal and laryngeal mucosa returned to basically normal (59.4 %) or scar-like (34.4 %).
CONCLUSIONS: LTB is usually found in middle-aged men, and patients\' symptoms are mainly hoarseness, abnormal sensation of pharyngeal, pharyngalgia, cough and sputum, and can be combined with tuberculous symptoms. These lesions mainly involve multiple subregions, mainly in the glottis, and can be combined with pharyngeal involvement. There were various types of lesions. Half of the patients were complicated with PTB, and chest CT was superior to X-ray in the detection of pulmonary lesions. After regular anti-tuberculosis treatment, the symptoms and morphology of the pharyngeal and laryngeal mucosa of most patients were significantly improved.
摘要：
目的：探讨临床特点，喉结结核(LTB)合并呼吸道结核的诊断及预后分析.
方法：对134例接受内镜检查并最终诊断为LTB的患者进行回顾性分析。患者的人口统计学特征，临床表现，内窥镜特征,辅助检查,分析影像学检查及预后特点。
结果：LTB患者的中位年龄为45.5岁（12至87岁），中位病程为3.0个月（0.1至72个月）。患者的症状主要表现为声音嘶哑（97.0%），咽部感觉异常（49.3%），咳嗽和痰(41.0%)，咽痛（39.6%），吞咽困难（10.4%）和呼吸困难（8.2%）。结核性症状阳性率为25.4%。内镜表现为病变主要累及声门(87.3%),表现为单侧病变（66.7％），接近全长的参与(88.0%)，粘膜波显着减少（86.3％），其次是声门上(43.3%)，声门下（24.6%）和咽部（15.7%）。病变可表现为肉芽肿性增生（66.4%），溃疡（65.7％）或肿胀和渗出（51.5％）。最终确诊为合并肺结核(PTB)的患者共75例(56.0%),胸部X线阳性率为25.6%，胸部CT阳性率为71.2%。共随访42例接受抗结核治疗的患者,73.8%的患者症状明显改善。咽喉黏膜形态基本恢复正常(59.4%)或瘢痕样(34.4%)。
结论：LTB通常见于中年男性，患者的症状主要是声音嘶哑，咽部感觉异常,咽痛,咳嗽和痰，并可伴有结核性症状。这些病变主要涉及多个亚区域，主要在声门，并可合并咽部受累。有各种类型的病变。一半的患者患有PTB，胸部CT对肺部病变的检测优于X线。常规抗结核治疗后,多数患者的咽部及喉黏膜症状及形态均有明显改善。
方法：对134例接受内镜检查并最终诊断为LTB的患者进行回顾性分析。患者的人口统计学特征，临床表现，内窥镜特征,辅助检查,分析影像学检查及预后特点。
结果：LTB患者的中位年龄为45.5岁（12至87岁），中位病程为3.0个月（0.1至72个月）。患者的症状主要表现为声音嘶哑（97.0%），咽部感觉异常（49.3%），咳嗽和痰(41.0%)，咽痛（39.6%），吞咽困难（10.4%）和呼吸困难（8.2%）。结核性症状阳性率为25.4%。内镜表现为病变主要累及声门(87.3%),表现为单侧病变（66.7％），接近全长的参与(88.0%)，粘膜波显着减少（86.3％），其次是声门上(43.3%)，声门下（24.6%）和咽部（15.7%）。病变可表现为肉芽肿性增生（66.4%），溃疡（65.7％）或肿胀和渗出（51.5％）。最终确诊为合并肺结核(PTB)的患者共75例(56.0%),胸部X线阳性率为25.6%，胸部CT阳性率为71.2%。共随访42例接受抗结核治疗的患者,73.8%的患者症状明显改善。咽喉黏膜形态基本恢复正常(59.4%)或瘢痕样(34.4%)。
结论：LTB通常见于中年男性，患者的症状主要是声音嘶哑，咽部感觉异常,咽痛,咳嗽和痰，并可伴有结核性症状。这些病变主要涉及多个亚区域，主要在声门，并可合并咽部受累。有各种类型的病变。一半的患者患有PTB，胸部CT对肺部病变的检测优于X线。常规抗结核治疗后,多数患者的咽部及喉黏膜症状及形态均有明显改善。
