卡介苗接种致结核性淋巴结炎51例临床特点分析  

Analysing clinical characters of tuberculous lymphnoditis in 51 cases duo to BCG inoculation

作　　者：张卫平[1] 韩文[1] 董菊[1] 多力坤.木扎帕 罗琼[1] 

机构地区：[1]新疆医科大学第一附属医院儿科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2009年第9期1223-1225,共3页Journal of Xinjiang Medical University

摘　　要：目的:分析卡介苗接种致结核性淋巴结炎临床特点,提高儿科医生识别此病临床诊断能力。方法:根据临床诊断标准、结核菌素试验(PPD)、影像学检查法、外周淋巴结病理活检或细胞学检查进行综合分析。结果:卡介苗接种侧腋下淋巴结肿大者15例(占29%)。卡疤同侧腋下淋巴结肿大并锁骨上淋巴结肿大者19例(占37%)。双侧腋下淋巴结肿大并卡疤侧锁骨上淋巴结肿大者17例(占33%)。PPD试验43例呈+++阳性反应,8例呈++++阳性反应。17例淋巴结病理活检,8例显示结核肉芽肿病变,9例显示干酪样坏死病变。34例淋巴结穿刺,细胞学检查显示有郎罕斯细胞浸润。结论:卡介苗接种时应充分溶解摇匀菌液,避免过量过深注射,一旦发生结核性淋巴结炎,>2cm以上需抗痨治疗,>4cm以上应寻求外科切除治疗。Objectives： To analyse the clinical characters of tuberculous lymphnoditis, Raising the ability of pediatric doctors to recognize the disease. Methods： We use clnical analyzing methods, PPD test, imaging investigation and biopsy of lymph nodes. Results： There were 15 cases with armpit lymphadenectasis in 29% under BCG side. There were 19 cases with armpit and supraclavicular lymphadenectasis in 37% under BCG side. There were 17 cases with both side armpit and supra clavicular lymphadenectasis in 33%. Forty three patients showed stronger positive results of PPD in responsiveness. 8 pateints showed the strongest positive results in responsiveness. There were 8 patients who were examed by lymphonode biopsy which showed tuberculous granuloma. There were 9 patients who were examed by lymphonode biopsy which showed caseous necrosis. There were 34 patients who were nyxixed in lymphonates which showed Langhan＇s cell infiltra tions. Conclusion： The solution of BCG should be dissolved totally avoiding deep and big dose injection. If there happened tuberculous lymphonoditis which were bigger than 2 cm, the patients should be treated by anti-tuberculous drugs. If there happened tuberculous lymphonoditis which were bigger than 4 cm the patients should be treated by surgery therapy as well as anti tuberculous drugs.

关 键 词：卡介苗 结核 淋巴结炎 

分 类 号：R52[医药卫生—内科学]