医学美学美容（中旬刊）
醫學美學美容（中旬刊）
의학미학미용（중순간）
MEDICAL AESTHETICS AND COSMETOLOGY
2014年
8期
19-20
,共2页
刘舰杭%蒋祥林%王君%唐小凡%唐锐臣%刘勇%樊瑜%徐仁脊
劉艦杭%蔣祥林%王君%唐小凡%唐銳臣%劉勇%樊瑜%徐仁脊
류함항%장상림%왕군%당소범%당예신%류용%번유%서인척
颈淋巴结结核诊治
頸淋巴結結覈診治
경림파결결핵진치
cervical lymph node tuberculosis%diagnosis%treatment
目的：探讨颈淋巴结结核更为科学的临床诊治方法。方法：回顾我院2009年2月至2012年5月期间10例颈淋巴结结核患者的诊治经过，结合文献对其诊断和治疗进行分析。结果：10例病例中，拟行颈淋巴结清扫术或颈淋巴结病灶清除（切除）术5例，其中4例因术中发现肿大淋巴结内为白色脓性或干酪性坏死组织改行病灶活检术，仅1例因其包块呈孤立囊性，大且壁厚完整切除；直接颈淋巴结活检术2例；纤维支气管镜活检术1例；予单纯药物抗结核治疗1例；HIV阳性女性患者予转HIV治疗中心治疗失访1例。病检8例均提示为结核性病理改变。所有患者均予抗结核治疗，明显好转8例；1例虽血沉恢复正常，但活检术后颈部包块进行性长大，邻近病灶融合，并破溃流脓，经会诊诊断为左颈淋巴结结核（复治）并予相应治疗后病灶稳定。结论：颈淋巴结结核作为淋巴系统结核甚至全身结核的一部分，从诊断到治疗应该树立全局和部分的观念，对病情进行综合分析，注重药物治疗，规范手术治疗，方可达到最佳治疗效果。
目的：探討頸淋巴結結覈更為科學的臨床診治方法。方法：迴顧我院2009年2月至2012年5月期間10例頸淋巴結結覈患者的診治經過，結閤文獻對其診斷和治療進行分析。結果：10例病例中，擬行頸淋巴結清掃術或頸淋巴結病竈清除（切除）術5例，其中4例因術中髮現腫大淋巴結內為白色膿性或榦酪性壞死組織改行病竈活檢術，僅1例因其包塊呈孤立囊性，大且壁厚完整切除；直接頸淋巴結活檢術2例；纖維支氣管鏡活檢術1例；予單純藥物抗結覈治療1例；HIV暘性女性患者予轉HIV治療中心治療失訪1例。病檢8例均提示為結覈性病理改變。所有患者均予抗結覈治療，明顯好轉8例；1例雖血沉恢複正常，但活檢術後頸部包塊進行性長大，鄰近病竈融閤，併破潰流膿，經會診診斷為左頸淋巴結結覈（複治）併予相應治療後病竈穩定。結論：頸淋巴結結覈作為淋巴繫統結覈甚至全身結覈的一部分，從診斷到治療應該樹立全跼和部分的觀唸，對病情進行綜閤分析，註重藥物治療，規範手術治療，方可達到最佳治療效果。
목적：탐토경림파결결핵경위과학적림상진치방법。방법：회고아원2009년2월지2012년5월기간10례경림파결결핵환자적진치경과，결합문헌대기진단화치료진행분석。결과：10례병례중，의행경림파결청소술혹경림파결병조청제（절제）술5례，기중4례인술중발현종대림파결내위백색농성혹간락성배사조직개행병조활검술，부1례인기포괴정고립낭성，대차벽후완정절제；직접경림파결활검술2례；섬유지기관경활검술1례；여단순약물항결핵치료1례；HIV양성녀성환자여전HIV치료중심치료실방1례。병검8례균제시위결핵성병리개변。소유환자균여항결핵치료，명현호전8례；1례수혈침회복정상，단활검술후경부포괴진행성장대，린근병조융합，병파궤류농，경회진진단위좌경림파결결핵（복치）병여상응치료후병조은정。결론：경림파결결핵작위림파계통결핵심지전신결핵적일부분，종진단도치료응해수립전국화부분적관념，대병정진행종합분석，주중약물치료，규범수술치료，방가체도최가치료효과。
Objective:To investigate the cervical lymph node tuberculosis more scientific methods of clinical diagnosis and treatment.Methods:Retrospective analysis from February 2009 to May 2012 period after the diagnosis and treatment of 10 cases of the cervical lymph node tuberculosis patients in our hospital,combined with the literature to analyze the diagnosis and treat-ment.Results:among the 10 cases,undergoing cervical lymphadenectomy or lymph node resection(resection)in 5 cases,including 4 cases for intraoperative found within the enlarged lymph nodes for white purulent or caseous necrosis organization change lesion biopsy,only 1 patients because of its mass is isolated cystic,large and thick wal directly complete resection,cervical lymph node biopsy in 2 case,fiberoptic bronchoscopy biopsy 1 case,to the pure drug anti-tuberculosis treatment in 1 case,1 case of HIV positive women for to the HIV treatment center was lost to fol ow-up.Pathological examination 8 cases showed changes of tuberculous pathology.Al patients to anti-tuberculosis treatment,8 cases improved significantly,1 cases although the ESR returned to normal,but the biopsy postoperative neck bag piece progressive grew up,adjacent lesions,and burst discharging,until consultation to the diagnosis of the left neck lymph node tuberculosis(re-lapse)and treated accordingly,the lesion turn to stability.Conclusion:The cervical lymph node tuberculosis as part of lymphatic tuberculosis even as the systemic tuberculosis,from diagnosis to treatment should establish the whole and part of the concept,the comprehensive analysis of the condition,pay at ention to drug treatment,standard operation treatment,only this can achieve the best therapeutic ef ect.
