摘要
目的对颈部淋巴结结核患者外科治疗效果的影响因素进行分析，为进行的初步临床分期提供依据。方法回顾性分析2012年12月至2015年9月陕西省结核病防治院收治的173例经细菌学或病理学诊断为颈部淋巴结结核并进行外科治疗的患者，对患者年龄、性别、体质量指数、病灶最大直径、受累淋巴结范围、是否并发糖尿病及是否为耐多药等7项与并发症发生情况相关的因素进行分析，分别采用单因素分析及多因素logistic回归分析，以P＜0．O5为差异有统计学意义。结果173例患者中，29例患者在术后出现并发症或复发。173例患者发生并发症的单因素分析结果显示，女性（22．6％，19／84）、病灶最大直径≥3cm（20．0％，21／105）、淋巴结受累范围≥2组（28．9％，22／76）、耐多药患者（63．6％，7／11）术后并发症发生率较高（χ2=4．013，P=0．045；χ2=5．815，P=0．016；χ2=14．422，P〈0．001；Fisher确切概率法，P〈0．001）；多因素logistic回归结果显示，病灶最大直径≥3cm（Wald χ2=4．178，OR=2．550，95％CI=1．021～7．434，P=0．031）、淋巴结受累范围≥2组（Waldy χ2=5．917，OR=2．987，95％CI=1．029～7．981，P=0．019）及耐多药（Waldy χ2=14．139，OR=8．917，95％CI=2．248～43．351，P=0．009）是影响颈部淋巴结结核术后疗效的危险因素。结论术前病灶最大直径、受累淋巴结范围及耐多药情况与颈部淋巴结结核术后外科治疗效果相关，可作为临床分期的依据。
Objective To analyze the relevant factors of surgical treatment results in patients with cervical tuberculous lymphadenitis and provide the basis for the preliminary clinical staging. Methods A total of 173 patents bacteriologically or pathologically diagnosed with cervical tuberculous lymphadenitis and then treated with surgery in our hospital from December, 2012 to Septemper, 2015 were retrospectively reviewed. Seven complica- tion-related factors including age, sex, body mass index, lesion size, nodal involvement area, whether complicated with diabetes as well as the existence of multidrug resistant were analyzed using univariate analysis and multivariate logistic regression analysis. P〈0.05 was considered as statistically significant. Results Of the 173 patients, 29 suffered operation complications or recurring cervical tuberculous lymphadenitis. Univariate analysis showed that, female （22.6%, 19/8,1）, lesion size ≥3 cm （20.0%, 21/105）, lymph node involvement ≥2 groups （28.9%, 22/76） and multidru-resistant positive （63.6%o, 7/11） were associated with the incidence of postoperative compli- cations （χ2 =4. 013, F=0. 045; χ2 =5. 815, P=0. 016; χ2=14. 422, P〈0. 001; Fisher exact probability test, P〈0. 001）. Multivariate logistic regression analysis showed that lesion size ≥3 cm （Wold χ2 = 4. 178, OR= 2. 550, 95GCI=1. 021-7. 434, P=0. 031）, lymph node involvement ≥2 groups （Wald χ2 =5. 917, OR=2. 987, 95%CI= 1. 029--7. 981, P=0. 019） and multidrug-resistant positive （Wold χ2 =14. 139, OR=8. 917, 95GCI=2. 248- 43. 351,P=0. 009） were significantly correlated with the incidence of surgical treatment results. Conclusion Pre- operative lesion size, nodal involvement area and multidrug-resistant are associated with incidence of surgical treat- ment results in cervical tuberculous lymphadenitis. This result can be used as the basis for clinical staging of cervical tuberculosis lymphadenitis.
出处
《中国防痨杂志》
CAS
2016年第7期559-563,共5页
Chinese Journal of Antituberculosis
基金
陕西省科学技术研究发展计划项目（2012k-16-12-05）
关键词
结核
淋巴结
结核
抗多种药物性
手术后并发症
治疗结果
Tuberculosis, lymph node
Tuberculosis, multidrug-resistant
Postoperative complications
Treatment outcome
