口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (12): 1104-1107.DOI: 10.13701/j.cnki.kqyxyj.2021.12.010

• 口腔颌面外科学研究 • 上一篇    下一篇

199例颌面颈部淋巴结结核病临床资料的回顾性分析

阿迪力江·赛买提, 吴旭彬, 张思敏, 买买提吐逊·吐尔地*   

  1. 新疆医科大学第一附属医院/附属口腔医院颌面创伤正颌外科 新疆 乌鲁木齐 830054
  • 收稿日期:2021-04-23 发布日期:2021-12-17
  • 通讯作者: *买买提吐逊·吐尔地,E-mail:maimaitituxun@aliyun.com
  • 作者简介:阿迪力江·赛买提(1983~ ),男,新疆人,主治医师,硕士,研究方向:口腔颌面部创伤、先天性或后天畸形、肿瘤外科治疗以及感染疾病的诊治。

Retrospective Study of 199 Cases of Tuberculous Lymphadenitis in Maxillofacial and Cervical Region

Adilijiang·SAIMAITI, WU Xubin, ZHANG Simin, Maimaititu·XUNTUERDI*   

  1. Department of Oral and Maxillofacial Trauma and Orthognathous Surgery, the First Affiliated Hospital of Xinjiang Medical University, Affiliated Hospital of Stomatology, Urumqi 830054, China
  • Received:2021-04-23 Published:2021-12-17

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摘要： 目的:分析199例颌面颈淋巴结结核患者的临床资料。方法:回顾性分析2010~2019年在我院通过病理检查确诊的199例患者临床资料。结果:男性62例,女性137例;45例患者有明显的疼痛不适、144例患者无明显疼痛不适;3例患者有其他部位的结核病史;临床检查触及的肿大淋巴结大部分为大小不一的多发淋巴结;肿大淋巴结在颈部分布情况Ⅴ区>Ⅱ区>Ⅰ区>腮腺区>Ⅵ区>Ⅲ区>Ⅳ区;CT诊断为考虑为结核47例、恶性肿瘤17例、感染性疾病19例、48例为性质待定;胸部X光片结果肺部或者胸膜有结核表现的为31例;比较前5年及后5年的典型的病理学特征即干酪样坏死出现率,差异有统计学意义(P<0.05);T-SPOT检查的患者为45例,结果为阳性者36例。结论:颌面颈部淋巴结结核为最常见的肺以外的结核性疾病,新疆地区作为高发地区有明显的年轻化的趋势,很要必要加强该群体的预防工作;临床上颈部淋巴结结核无特定的临床表现,典型的病理学特征出现率明显下降,对病理诊断带来了一定的困难;诊断方面CT增强扫描、T-SPOT检查的参考价值明显高于其他检查。

关键词: 颌面颈部, 淋巴结结核

Abstract: Objective: To analyze the clinical data of 199 patients with tuberculous lymphadenitis in maxillofacial and cervical region. Methods: The clinical data of 199 patients confirmed by pathological examination in our hospital from 2010 to the end of 2019 were retrospective analyzed. Results: There were 62 males and 137 females. Forty-five patients had obvious pain and discomfort. Only three patients had tuberculosis history. Most of the cases were multiple enlarged lymphonodus with different sizes. The distribution frequency of enlarged lymphonodus in the maxillofacial and cervical region were Ⅴ>Ⅱ>Ⅰ> parotid region >Ⅵ>Ⅲ>Ⅳ. CT diagnosis included 47 cases of tuberculosis, 17 cases of malignant tumors, 19 cases of infectious diseases, and 48 cases of uncertain. Chest X-ray examination showed tuberculosis of lung or pleura in 31 cases. The relevance rate of caseous necrosis between early and last five years pathological specimen was obviously different (P<0.05). There were 36 positive patients out of 45 patients with T-SPOT examination. Conclusion: Tuberculous lymphadenitis in maxillofacial and cervical region is the most common extrapulmonary tuberculosis. It is necessary to strengthen the prevention of young people. CT enhanced scan and T-SPOT examination had higher diagnostic value than other examinations.

Key words: maxillofacial and cervical region, tuberculous lymphadenitis