功能性区域颈淋巴结清扫术在治疗多发性颈淋巴结核中的临床研究

Clincial investigation of functional neck dissection in the treatment of multiple cervical tuberculous lymphadenopathy

目的探讨功能性区域颈淋巴结清扫术组(研究组)患者和传统颈淋巴结核病灶清除术组(对照组)在多发性(多区)颈淋巴结核中的应用价值。方法选择2006年1月—2008年5月收治的经保守治疗无效,病灶出现液化或窦道的76例多发颈部淋巴结核患者,将患者随机分成研究组和对照组,对比两组术后复发率、颈部功能情况、平均住院时间、平均住院费用等。结果研究组术后3个月复发1例(2.56%,1/39),对照组术后3个月复发7例(18.92%,7/37)(P<0.05);研究组术后3个月复查颈部功能全部正常,对照组术后3个月复查颈部功能不正常例数6例(16.22%)(P<0.05)。研究组平均住院花费7 000元,对照组平均住院花费6 700元,两组差异无统计学意义;研究组平均住院天数11 d,对照组平均住院天数28 d(P<0.05)。结论多发性颈淋巴结核患者保守治疗无效后施行功能性区域颈淋巴结清扫术,效果明显,优于颈部淋巴结核病灶清除术。

Objective To compare the clinical efficacy of traditional excision of involved lymph nodes and functional neck dissection in the treatment of patients with multiple cervical tuberculous lymphadenopathy（MCTLP）.Methods From Jan 2006 to May 2008,76 patients with MCTLP who presented with focal liquefaction or sinus formation after ineffective conservative therapy were randomly divided into study group（functional neck dissection） and control group.Data regarding the 3-month recurrence rate,postoperative neck function,the mean hospitalization days and medical costs of the 2 groups were compared.Results There was significant difference in relapse rate 3 months postoperatively between study group（1 case,2.56%） and control group（7 cases,16.22%）（0.05）.Neck function 3 months postoperatively was normal in all of the patients of study group,but was abnormal in 6 cases of control group（P〈0.05）.The mean medical expenses during hospitalization showed no significant difference（7000 yuan vs.6700 yuan）.There was marked difference in mean hospitalization days between the study group（11 days） and control group（28day）（P〈0.05）.Conclusions Functional neck dissection is a better surgical approach than traditional regional excision for the treatment of patients with MCTLP after ineffective conservative therapy.