国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2014年
6期
783-785
,共3页
颈部淋巴结结核%诊断%药物疗法
頸部淋巴結結覈%診斷%藥物療法
경부림파결결핵%진단%약물요법
Lymph node tuberculosis%Diagnosis%Drug therapy
目的 探讨颈部淋巴结结核的临床特点,提高颈部淋巴结结核的诊治水平.方法 对2005年12月至2010年12月在我院确诊并治疗的126例颈部淋巴结结核患者的临床资料进行回顾性分析.结果 126例病例中,结节型60例,占47.6％,浸润型27例,占21.4％,脓肿型22例,占17.5％,窦道型17例,占13.5％;合并肺结核58例,占46.0％,局部疼痛53例,占42.1％,咳嗽41例,占32.5％,低热21例,占16.7％,盗汗19例,占15.1％.乏力14例,占11.1％,消瘦15例.6个月疗程组治愈率为60.3％,显效率为39.7％; 12个月疗程组治愈率为95.6％,显效率为4.4％.随访2年中,6个月疗程组复发3例,占5.2％.12个月疗程组复发2例,占2.9％.结论 颈部淋巴结结核多数不伴有典型的结核病全身中毒症状,易产生误诊、漏诊,应根据淋巴结病理活检、结素试验、结核抗体试验等检查明确诊断,难以确诊者可以诊断性治疗;应重视淋巴结抗酸菌L型感染,避免漏诊;治疗原则与肺结核相同,溃疡型及窦道型可结合局部外科清创或抽脓治疗.疗程应适当延长至1年或以上,以提高治愈率,降低复发率.
目的 探討頸部淋巴結結覈的臨床特點,提高頸部淋巴結結覈的診治水平.方法 對2005年12月至2010年12月在我院確診併治療的126例頸部淋巴結結覈患者的臨床資料進行迴顧性分析.結果 126例病例中,結節型60例,佔47.6％,浸潤型27例,佔21.4％,膿腫型22例,佔17.5％,竇道型17例,佔13.5％;閤併肺結覈58例,佔46.0％,跼部疼痛53例,佔42.1％,咳嗽41例,佔32.5％,低熱21例,佔16.7％,盜汗19例,佔15.1％.乏力14例,佔11.1％,消瘦15例.6箇月療程組治愈率為60.3％,顯效率為39.7％; 12箇月療程組治愈率為95.6％,顯效率為4.4％.隨訪2年中,6箇月療程組複髮3例,佔5.2％.12箇月療程組複髮2例,佔2.9％.結論 頸部淋巴結結覈多數不伴有典型的結覈病全身中毒癥狀,易產生誤診、漏診,應根據淋巴結病理活檢、結素試驗、結覈抗體試驗等檢查明確診斷,難以確診者可以診斷性治療;應重視淋巴結抗痠菌L型感染,避免漏診;治療原則與肺結覈相同,潰瘍型及竇道型可結閤跼部外科清創或抽膿治療.療程應適噹延長至1年或以上,以提高治愈率,降低複髮率.
목적 탐토경부림파결결핵적림상특점,제고경부림파결결핵적진치수평.방법 대2005년12월지2010년12월재아원학진병치료적126례경부림파결결핵환자적림상자료진행회고성분석.결과 126례병례중,결절형60례,점47.6％,침윤형27례,점21.4％,농종형22례,점17.5％,두도형17례,점13.5％;합병폐결핵58례,점46.0％,국부동통53례,점42.1％,해수41례,점32.5％,저열21례,점16.7％,도한19례,점15.1％.핍력14례,점11.1％,소수15례.6개월료정조치유솔위60.3％,현효솔위39.7％; 12개월료정조치유솔위95.6％,현효솔위4.4％.수방2년중,6개월료정조복발3례,점5.2％.12개월료정조복발2례,점2.9％.결론 경부림파결결핵다수불반유전형적결핵병전신중독증상,역산생오진、루진,응근거림파결병리활검、결소시험、결핵항체시험등검사명학진단,난이학진자가이진단성치료;응중시림파결항산균L형감염,피면루진;치료원칙여폐결핵상동,궤양형급두도형가결합국부외과청창혹추농치료.료정응괄당연장지1년혹이상,이제고치유솔,강저복발솔.
Objective To investigate the clinical characteristics of cervical lymph node tuberculosis,and to improve diagnosis and treatment of cervical lymph node tuberculosis.Method From December 2005 to December 2010,126 cases of cervical lymph node tuberculosis in our hospital were diagnosed and treated,whose clinical data was retrospectively analyzed.Results In 126 patients,there were 60 cases of nodular type (47.6％),27 cases of infiltrative type (21.4％),22 cases of abscess type (17.5％),17 cases of sinus type (13.5％).There were 58 cases of pulmonary tuberculosis (46.0％),53 cases of local pain (42.1％),41 cases of cough (32.5％),21 cases of low-grade fever (16.7％),19 cases of night sweat (15.1％),14 cases of fatigue (11.1％),15 cases of weight loss.The cure rate and effective rate of 6 month course were 60.3％,39.7％ respectively,those of 12 month course were 95.6％,4.4％ respectively.Followed up for 2 years,3 cases in 6 months treatment group relapsed,accounting for 5.2％; 2 cases in 12 months treatment group relapsed,accounting for 2.9％.Conclusions Most of cervical lymph node tuberculosis is not associated with typical symptoms of systemic poisoning,prone to misdiagnosis.It should be confirmed based on lymph node biopsy,tuberculin test,tuberculosis antibody test and other tests.None confirmed cases should receive diagnostic treatment.L-shaped lymph acid-fast bacterial infection should be paid attention to,avoiding misdiagnosis.Treatment principle of cervical lymph node tuberculosis is identical with tuberculosis,ulcer and sinus type can be combined with local surgical debridement or pumping pus treatment.Treatment should be extended to a year or more,in order to improve the cure rate and lower recurrence rate.
