Wegener肉芽肿病的头颈部临床表现及处理  

Head and neck manifestations and management of Wegener′s granulomatosis

作　　者：李清明[1] 张宝泉[1] 彭培宏[1] 高志强[1] 尹海金[1] 冯国栋[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院耳鼻咽喉-头颈外科,北京100730

出　　处：《临床耳鼻咽喉科杂志》2005年第24期1112-1115,共4页Journal of Clinical Otorhinolaryngology

摘　　要：目的:探讨Wegener肉芽肿病(WG)在耳鼻咽喉-头颈部的临床表现及处理方法。方法:回顾性分析42例WG患者的临床资料,分别对其临床特征、炼茄屎愍餐肪蓖饪票硐帧⒒罴旒翱怪行粤O赴赴士固澹?NCA)检测及治疗方法进行记录分析。治疗主要采用环磷酰胺加泼尼松联合应用的内科治疗。结果:全部病例均呈现多系统、多器官受累,34例(81.0%)以鼻部受累为最明显,32例(76.2%)肺受累。首发症状以鼻部为首位20例(47.6%),其次发热11例(26.2%)。37例行活检,其中25例确诊,确诊率为67.6%。ANCA检测总阳性率为97.4%。结论:WG在耳鼻咽喉-头颈部表现复杂多变,ANCA检测和活检是诊断的主要手段。主要以内科治疗为主,手术治疗是有选择性的。Objective：To explore the characteristic and management of Wegener＇s granulomatosis in head and neck. Method：Forty-two cases with Wegener＇s granulornatosis were retrospectively analyzed chinical characteristics, head and neck manifestatians, biopsy, ANCA test, and management were respectively recorded. Cyclophosphamide and Prednison are the mainstay of medical therapy. Result： All cases presented with mutiple organ systems involvement. Nasal involvement occurred most in head and neck,the occurred rate was 81.0%, the rate of first-occurred signs and symptoms was 47.6%. The diagnosised rate by biopsy was 67.6%. The total positive rate of ANCA test was 97.4 %. Conclusion： Head and neck involvement in Wegener＇s granulomatosis is most common and complicated. ANCA test and biopsy are the most main means in the diagnosis of Wegener＇s granulomatosis. Medical therapy is the mainstay of treatment in Wegener＇s granulomatosis,whereas surgery is reserved for selected head and neck manifestations.

关 键 词：WEGENER肉芽肿 耳鼻咽喉疾病 头颈 

分 类 号：R743.3[医药卫生—神经病学与精神病学]