改良式小切口病灶清除术联合功能性颈淋巴结清扫术对颈部淋巴结核的治疗效果观察

Observation of the therapeutic effect of modified small incision lesion clearance combined with functional neck lymph node dissection on cervical lymphatic tuberculosis

目的探讨改良式小切口病灶清除术联合功能性颈淋巴结清扫术(FND)治疗颈部淋巴结核的临床效果。方法选取2020年8月至2022年8月河北省胸科医院普外科收治的颈部淋巴结核患者104例,采用随机数字表法分为观察组和对照组,每组52例。观察组采用改良式小切口病灶清除术联合FND治疗,对照组采用常规切口病灶清除术联合FND治疗。比较两组的治疗效果、手术相关指标、切口愈合情况、术后疼痛程度及并发症发生情况。结果两组治疗总有效率比较差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,手术时间、切口长度、引流管拔除时间、住院时间、切口瘢痕长度、切口愈合时间短于对照组,切口愈合良好率高于对照组,术后12、24、48、72 h静息及活动状态下的疼痛视觉模拟量表评分低于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为3.85%,明显低于对照组的17.31%,差异有统计学意义(P<0.05)。结论改良式小切口病灶清除术联合FND治疗颈部淋巴结核可促进术后恢复及切口愈合,减轻术后疼痛,且并发症较少,值得临床应用。

Objective To investigate the clinical effect of modifi ed small incision lesion clearance combined with functional neck lymph node dissection(FND)for the treatment of cervical lymph node tuberculosis.Method One hundred and four patients with cervical lymphatic tuberculosis admitted to the Department of General Surgery of Hebei Chest Hospital from August 2020 to August 2022 were selected and divided into observation group and control group using the random number table method,with 52 cases in each group.The observation group was treated with modifi ed small incision lesion removal combined with FND,and the control group was treated with conventional incision lesion removal combined with FND.The treatment effect,surgery-related indexes,incision healing,postoperative pain degree and complication rate of the two groups were compared.Result There was no statistically signifi cant difference in the total effective rate of treatment between the two groups(P>0.05).The intraoperative bleeding of the observation group was less than that of the control group,the operation time,incision length,drain removal time,hospital stay,incision scar length,incision healing time were shorter than that of the control group,the incision healing rate was higher than that of the control group,and the visual analogue scale(VAS)scores of pain in the resting and active states were lower than that of the control group at 12,24,48,and 72 h postoperatively,and the differences were statistically signifi cant(P<0.05).The incidence of postoperative complications in the observation group was 3.85%,which was signifi cantly lower than the 17.31%in the control group,and the difference was statistically signifi cant(P<0.05).Conclusion Modifi ed small incision lesion removal combined with FND for cervical lymphatic tuberculosis could promote postoperative recovery and incision healing,reduce postoperative pain,and had fewer complications.