功能性颈淋巴结清扫术治疗颈部淋巴结核的疗效观察

Therapeutic effect of functional cervical lymph node dissection for cervical lymphatic tuberculosis

目的探讨功能性颈淋巴结清扫术治疗颈部淋巴结核的疗效。方法选择2012年6月—2016年5月在河北省胸科医院胸外科收治的颈淋巴结核病例80例,按随机数字表法分为研究组和对照组,每组各40例,研究组采用功能性颈淋巴结清扫术治疗,对照组采用颈淋巴结核病灶清除术治疗,比较两者在术后住院时间、术后引流时间、清除淋巴结数目、淋巴结核阳性率、切口一期愈合率、术后复发率及术后颈肩部功能情况,比较手术前后炎性因子变化。结果研究组术后住院时间、引流时间均明显低于对照组(t/P=16.015/0.000, t/P=12.360/0.000),清除淋巴结数目明显多于对照组(χ~2/P=27. 990/0. 000),淋巴结结核阳性率研究组低于对照组(χ~2/P=14. 160/0. 000);切口一期愈合率研究组明显优于对照组(χ~2/P=6. 050/0. 014);2组术后15d血清炎性细胞因子(CRP、IL-6、ESR)水平均高于术前,但研究组各指标水平低于对照组(t/P=10.456/0. 001,χ~2/P=7. 255/0. 001,χ~2/P=4. 979/0. 001);随访1年研究组术后复发率低于对照组(χ~2/P=5. 165/0.023),2组颈肩部功能障碍比较差异无统计学意义(P>0.05)。结论功能性颈淋巴结清扫术治疗颈部淋巴结核,术后引流时间、住院时间短,术后复发率低,不影响颈肩部功能。

Objective To investigate the efficacy of functional neck dissection in the treatment of cervical lymphadenopathy. Methods Eighty cases of cervical lymphatic tuberculosis admitted to the Department of Thoracic Surgery, Hebei Chest Hospital from June 2012 to May 2016 were randomly divided into study group and control group, 40 cases in each group. The study group used functions. Cervical lymph node dissection was used for treatment. The control group was treated with cervical lymphatic tuberculosis. The postoperative hospital stay, postoperative drainage time, number of cleared lymph nodes, lymph node positive rate, first-stage incision healing rate, and postoperative recurrence were compared. Rate and postoperative neck and shoulder function. Results The postoperative hospital stay and drainage time of the study group were significantly lower than the control group ( t / P =16.015/0.000, t / P =12.360/0.000), and the number of lymph nodes cleared was significantly higher than that of the control group (χ^2/ P =27.990/0.000). The positive rate of lymph node tuberculosis was lower in the study group than in the control group (χ^2/ P =14.160/0.000); the first-stage incision healing rate was significantly better in the study group than in the control group (χ^2/ P =6.050/0.014); The levels of cytokine levels (CRP, IL-6, ESR) were higher than those before surgery, but the levels of the indicators in the study group were lower than those in the control group ( t / P =10.456/0.001,χ^2/ P =7.255/0.001,χ 2/ P = 4.979/0.001); The recurrence rate of the study group was lower than that of the control group (χ^2/ P =5.165/0.023). There was no significant difference in neck and shoulder dysfunction between the two groups ( P >0.05). Conclusion Functional neck dissection for the treatment of cervical lymph node, with postoperative drainage time, short hospital stay, low postoperative recurrence rate, etc., does not affect neck and shoulder function.