63例结核性淋巴结炎临床分析

Analyzed in 63 patients with lymph node tuberculosis in a clinical review

目的分析淋巴结结核患者发病情况、诊断方法和治疗效果。方法回顾性分析2000年4月至2006年4月间63例本院确诊的淋巴节结核病人临床资料。结果颈淋巴结最常见,40例占63.4%。其次为腋下淋巴结结核17例(26.9%)、其它部位6例(9.5%)。多数病人结核菌素试验呈阳性反应。细针针吸活检所获得标本,51例作结核分支杆菌培养检查。18例(18/51)病人分离出结核分枝杆菌,敏感性极高(35.3%)。结论淋巴结结核在我国仍是一个常见病,且以外地民工多见。应充分重视。可采用结核菌素皮肤试验和细针活检术(FNA)相结合,诊断并不困难。

Objective To evaluate patient profiles, diagnostic approaches, and treatment strategies in patients with lymph node tuberculosis. Methods Demographic data, diagnostic findings, and therapies were retrospectively analyzed in 63patients with lymph node tuberculosis who were hospitalized between 2000.4 and 2006.4. Results 18 patients（28.6% ） were natives, and 45 （71.4%） were immigrants. The cervical lymph nodes were most frequently involved （63.4%） , followed by the mediastinal lymph nodes （26.9%） and the axillary lymph nodes （9.5%）. Most patients showed a positive response to tuberculin skin testing. Lymph node excision and fineneedle aspiration （FNA） were similarly effective in obtaining sufficient material for histologic and microbiological analysis. Mycobacterium tuberculosis was identified in 35.3% of patients by microbiological testing, and culture methods showed the highest sensitivity. Conclusion Lymph node tuberculosis is still an important issue in our countries and has to be considered in differential diagnosis. The best approach appears to be a combination of skin testing and FNA. Negative results in the identification of M tuberculosis do not exclude the diagnosis of lymph node tuberculosis.