淋巴结清扫术治疗318例颈淋巴结结核的临床分析  

Clinical analysis of lymph node dissection for the treatment of cervical tuberculous lymphadenitis in 318 cases

作　　者：蒋钰辉 房明浩[2] 戴希勇 吴骁伟[3] JIANG Yuhui;FANG Minghao;DAI Xiyong;WU Xiaowei(Dept.of Surgery,Wuhan Pulmonary Hospital&Wuhan Institute for Tuberculosis Control,Wuhan 430030,Hubei,China;Dept.of Emergency,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;Dept.of Thoracic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]武汉市肺科医院外科/武汉市结核病防治所,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院急诊外科,湖北武汉430030 [3]华中科技大学同济医学院附属同济医院胸外科,湖北武汉430030

出　　处：《武汉大学学报（医学版）》2021年第6期975-979,共5页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金面上项目(编号:2020CFB740;2019CFB437)。

摘　　要：目的:探讨淋巴结清扫术治疗颈淋巴结结核的治疗效果及风险。方法:回顾性分析武汉市肺科医院外科自2014年10月至2016年10月行淋巴结清扫术的318例颈淋巴结结核的临床类型、手术方法、治疗效果及并发症。结果:318例患者中,结节型6例,浸润型90例,脓肿型178例,溃疡型44例。行上颈部手术142例,下颈部手术122例,双侧或同侧两部位手术51例,双侧三个以上部位手术3例。术后重要并发症(发生率)主要为神经损伤(4.40%)、血管损伤(2.52%)、淋巴瘘(2.83%)及伤口愈合不良(4.09%)。术后复发14例,复发率4.40%,治愈率95.60%。结论:淋巴结清扫术治疗颈淋巴结结核效果确切,对颈部功能影响小,是理想的手术方式之一。术中操作应耐心细致,减少手术并发症,降低复发率。Objective:To investigate the effect and complications of lymph node dissection in the treatment of cervical tuberculous lymphadenitis.Methods:We retrospectively analyzed the clinical types,surgical methods,therapeutic effect,and complications of 318 cervical lymph node tuberculosis patients with lymph node dissection in Surgery Department of Wuhan Pulmonary Hospital from October 2014 to October 2016.Results:Of the 318 cases of lymph node tuberculosis,6 were in nodular type,90 were in infiltrated type,178 were in abscess type,and 44 were in ulcer type.The incisions of 142 cases were in upper neck,122 cases were in lower neck,51 cases in bilateral neck or two operative sites in ipsilateral neck,and 3 cases had more than three incisions in ipsilateral neck.The important complications(occurrence rate) were mainly nerve injury(4.40%),vascular injury(2.52%),lymphatic fistula(2.83%) and impaired wound healing(4.09%).19 cases recurred after operation.The recurrence rate was 4.40% and the cure rate was 95.60%.Conclusion:Lymph node dissection was one of the ideal surgical methods in treatment of cervical tuberculous lymphadenitis,which retained the neck function and the effect was exact at the same time.For reducing surgical complications and recurrence,surgical operations should be patiently and carefully.

关 键 词：淋巴结清扫术 淋巴结 结核 手术治疗 并发症 

分 类 号：R615[医药卫生—外科学]