功能性区域颈淋巴结清扫术治疗多发性颈淋巴结结核的效果观察

Effect of functional radical neck dissection on multiple cervical lymph node tuberculosis

目的:探讨功能性区域颈淋巴结清扫术(FRND)治疗多发性颈淋巴结结核(CLNT)的临床效果。方法:将2017年5月至2020年4月濮阳市第五人民医院收治的多发性CLNT患者152例作为研究对象,并将其按照随机数字表法分为FRND组(76例)与颈淋巴结结核病灶清除术(CLND)组(76例),FRND组采用FRND治疗,CLND组采用CLND治疗,比较两组围术期情况、淋巴结清除效果、复发率、颈功能和切口愈合情况、并发症发生率。结果:与CLND组比较,FRND组术后引流时间、切口愈合时间、住院时间较短( P<0.05);与CLND组比较,FRND组淋巴结清除数量较少,复发率较低( P<0.05);术后随访1年,FRND组术后颈功能正常率(97.37%,74/76)、切口愈合良好率(98.68%,75/76)较CLND组(80.26%、78.95%)高, P<0.05;FRND组并发症发生率(2.63%,2/76)较CLND组(13.16%,10/76)低, P<0.05。 结论:采用FRND治疗多发性CLNT,无需过多清扫淋巴结,并发症少,可减轻对术后颈功能和机体恢复的影响,且不会增加复发风险,可提高预后效果。

Objective To investigate the effect of functional radical neck dissection(FRND)on multiple cervical lymph node tuberculosis(CLNT).Methods A total of 152 patients with multiple CLNT in the Fifth People’s Hospital of Puyang from May 2017 to April 2020 were taken as the research objects,and they were divided into FRND group(76 cases)and cervical lymph node dissection(CLND)group(76 cases)according to random number table method.FRND group was treated with FRND,CLND group was treated with CLND.The perioperative situation,lymph node clearance effect,recurrence rate,neck function and wound healing,and incidence of complications were compared between the two groups.Results Compared with CLND group,FRND group had shorter postoperative drainage time,incision healing time and hospital stay(P<0.05).Compared with CLND group,FRND group had less lymph node clearance and lower recurrence rate(P<0.05).After 1-year follow-up,the normal rate of postoperative neck function(97.37%,74/76)and good wound healing rate(98.68%,75/76)in the FRND group were higher than those in the CLND group(80.26%and 78.95%),P<0.05.The incidence of complications in FRND group(2.63%,2/76)was lower than that in CLND group(13.16%,10/76),P<0.05.Conclusions The use of FRND to treat multiple CLNT does not require too much lymph node dissection and has fewer complications.It can reduce the impact on postoperative neck function and body recovery,without increasing the risk of recurrence,and can improve the prognosis.