与艾滋病相关的Kaposi肉瘤在耳鼻咽喉头颈部的临床表现  

Clinical manifestation of Kaposi sarcoma in otorhinolaryngology head and neck surgery

作　　者：于德先[1] 皮士军[1] 张文山[1] 

机构地区：[1]山东省枣庄市立医院耳鼻咽喉科,277100

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第3期241-243,共3页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的提高对Kaposi肉瘤及其与人类免疫缺陷病毒（human immunodeficiencyvirus，HIV）感染关系的认识，提高对艾滋病的诊断处理能力。方法回顾性分析作者援助坦桑尼亚期间，121例就诊于耳鼻喉咽科的HIV感染并发Kaposi肉瘤患者的临床表现及其观察随访结果。结果121例患者中，男46例，女75例；年龄5—65岁，中位数30岁；病史5d至20个月，中位数1个月。临床表现为进行性鼻塞、反复鼻腔流血25例（20．66％），鼻腔检查见一侧或双侧鼻腔紫红色结节样病变，触之易出血；口腔、咽喉部黏膜病变39例（32．23％），其中上腭或舌体黏膜紫红色斑片样病变15例，牙龈紫红色结节7例，颊黏膜紫红色结节8例，咽部黏膜结节样病变9例；扁桃体暗红色Ⅱ。至Ⅲ。肿大10例（8．26％）；颈部无痛性肿块进行性增大12例（9．92％），均为颈部淋巴结肿大或融合。鼻面部及头颈部皮肤紫黑色结节35例（28．92％），其中结节样病变合并溃疡10例。患者生存状况随访：1年内死亡85例，1年生存率21．48％（26／121）；生存2年以上者12例，2年生存率9．92％（12／121）。结论随着Kaposi肉瘤病程的不断进展，其临床可表现为皮肤或黏膜的紫红色或紫黑色斑片、瘤样结节、结节溃疡等不同的病变形式。未经治疗的Kaposi肉瘤患者很快死亡。Objective To improve the knowledge of Kaposi sarcoma and the relationship between Kaposi sarcoma and human immunodeficiency virus （HIV） infection, and to improve the ability to diagnose and treat Kaposi sarcoma and acquired immune deficiency syndrome （AIDS）. Methods Symptoms, signs and results of 121 patients encountered in the department of otorhinolaryngology head and neck surgery in Tanzania, who was diagnosed as Kaposi sarcoma actually with HIV infection and AIDS, were retrospectively analyzed in this study. Results There were 46 males and 75 females with age ranged from 5 to 65 years, medium 30 year. The mucous membranes and skin lesions was the most commonly seen clinical manifestation in 121 cases, these lesions appeared as raised blotches or lumps that might be purple, brown, or red, early stages typical lesions began as flat or slightly raised colored spots. Among the cases reported here, 25 patients（20.66% ）showed progressive nose blockage and nose bleeding and the purple-red new-grows were found in the nose of these patients. Fifteen patients （ 12.40% ） had flat or slightly raised colored spots in their mucous membrane of mouth （ palate or tongue ） , and in other 7 patients, purple small lumps were found in the gums of the patients. There were same lesions in their pharynx in 9 cases. In 10 patients （8.26%） , Kaposi sarcoma was found in tonsil looked like tonsillitis with enlarged tonsils by two to three degree. Twelve patients（9.92% ） had masses in the neck with no pain. Thirty-five patients（28.92% ）had lesions of purple black nodules, including 10 patients who had the same lesions with ulcer formation in the nodules. All patients had been followed-up for at least two-years. Eighty-five patients passed away in one year, survival rate of one year was 21.48% （26/121）, only 12 patients survived from the disease over two years, two years＇ survival rate was 9.92% （ 12/121 ）. Conclusions Kaposi sarcoma is the characteristic disease for AIDS, mainly found on the memb

关 键 词：HIV感染 获得性免疫缺陷综合征 肉瘤 卡波西 耳鼻咽喉疾病 

分 类 号：R512.91[医药卫生—内科学]