外科手术治疗颈淋巴结核的临床疗效探讨  

Assessment of the clinical efficacy of surgical treatment for cervical lymph node tuberculosis

作　　者：方谭玮 刘腾 范明 吴逊 Fang Tanwei;Liu Teng;Fan Ming;Wu Xun(Department of Surgery,Hunan Provincial Chest Hospital,Changsha 410013,China;Department of the 2nd Department of Thoracic Surgery,Hunan Cancer Hospital,Changsha 410o13,China)

机构地区：[1]湖南省胸科医院外科,长沙410013 [2]湖南省肿瘤医院胸外二科,长沙410013

出　　处：《中华老年医学杂志》2024年第2期187-191,共5页Chinese Journal of Geriatrics

基　　金：湖南省自然科学编号(2019JJ60013)。

摘　　要：目的探讨外科手术在颈淋巴结核临床治疗中的效果及应用情况。方法选择110例于2020年1月至2022年12月在湖南省胸科医院结核外科进行治疗的患者,均确诊为颈淋巴结核。根据患者意愿分为2组:药物治疗组患者60例,予以常规药物治疗;手术组患者50例,予以外科手术治疗。对比、分析和统计2组的临床效果、复发率、并发症、生活质量以及满意度等情况。结果临床总有效率手术组高于药物治疗组(94.00%和70.00%,χ^(2)=10.170,P=0.001),60岁以下患者手术组疗效优于药物治疗组(64.29%和40.00%,χ^(2)=-6.996,P=0.035),60岁及以上患者手术与药物治疗效果无差异(54.55%和40.00%,Z=3.842,P=0.146);复发率方面手术组低于药物治疗组(8.00%和46.67%,χ^(2)=19.767,P<0.001);并发症总发生率手术组低于药物治疗组(8.00%和21.67%,χ^(2)=3.899,P=0.048);生活质量手术组各项评分均高于药物治疗组[躯体功能:(64.02±4.49)分和(76.11±4.47)分,t=14.090,P<0.001];[物质功能:(66.50±2.39)分和(81.03±2.28)分,t=32.417,P<0.001];[心理功能:(62.98±2.51)分和(79.24±2.50)分,t=33.892,P<0.001];[社会功能:(63.12±3.39)分和(76.08±3.51)分,t=19.645,P<0.001]。临床总满意度手术组高于药物组(90.00%和66.67%,χ^(2)=8.455,P=0.004)。结论颈淋巴结核患者实施手术治疗,其疗效更好,并发症更少,预后效果更佳,具有较高的临床应用价值。Objective To assess the effectiveness and practical value of surgery in clinical treatment of cervical lymph node tuberculosis.Methods110 patients receiving surgical treatment for tuberculosis at Hunan Provincial Chest Hospital between January 2020 and December 2022 were selected,all of whom were diagnosed with cervical lymph node tuberculosis.According to patient preferences,they were divided into two groups,a drug treatment group consisted of 60 patients receiving conventional Western medicine treatment and a surgical treatment group of 50 patients receiving surgical treatment.Statistical analysis was made to compare the clinical efficacy,recurrence rate,complications,quality of life,and patient satisfaction between the two groups.ResultsThe overall clinical effectiveness rate was higher in the surgical treatment group than in the drug treatment group(94.00%vs.70.00%,χ^(2)=10.170,P=0.001),with the rate higher in the surgical treatment group than in the drug treatment group for patients under 60 years of age(64.29%vs.40.00%,χ^(2)=-6.996,P=0.035),but there was no difference in therapeutic efficacy between the two groups for patients aged 60 and above(54.55%vs.40.00%,Z=3.842,P=0.146).Compared with the drug treatment group,the surgical treatment group had a lower recurrence rate(8.00%vs.46.67%,χ^(2)=19.767,P<0.001)and a lower rate of complications(8.00%vs.21.67%,χ^(2)=3.899,P=0.048),but higher scores of quality of life in all four domains(physical function:64.02±4.49 vs.76.11±4.47,t=14.090,P<0.001;material life:66.50±2.39 vs.81.03±2.28,t=32.417,P<0.001;psychological function:62.98±2.51 vs.79.24±2.50,t=33.892,P<0.001;social function:63.12±3.39 vs.76.08±3.51,t=19.645,P<0.001)and a higher level overall patient satisfaction(90.00%vs.66.67%,χ^(2)=8.455,P=0.004).ConclusionsSurgical treatment for cervical lymph node tuberculosis patients has better efficacy,fewer complications and better prognosis and is clinically practical and highly valuable.

关 键 词：分枝杆菌 淋巴结核 外科手术 治疗结果 

分 类 号：R653[医药卫生—外科学]