Oktay Mehmet F, Topcu Ismail, Senyigit Abdurrahman, Bilici Aslan, Arslan Adem, Cureoglu Sebahattin, Yildirim Muzeyyen
Department of Otolaryngology, Dicle University Medical School, Diyarbakir, Turkey.
J Laryngol Otol. 2006 Feb;120(2):129-32. doi: 10.1017/S002221510500277X. Epub 2005 Nov 25.
To investigate the efficacy of medical antituberculous treatment in patients with tuberculous cervical lymphadenitis (TCL).
In the period 1996-2002, 73 TCL patients were reviewed and the results of clinical and laboratory testing were documented. The efficacy of a four-drug chemotherapy regimen was investigated.
Purified protein derivatives (PPD) skin test results were positive in 58 (79 per cent) patients. Chest X-rays revealed changes consistent with tuberculosis in nine (12.3 per cent) patients. The mean duration of medical treatment was 10.04 months. In follow-up evaluation, 14 (20 per cent) patients were considered suspicious for resistant TCL and total excision of all nodes was performed. Histopathology confirmed TB in only 10 of these cases.
The high incidence of residual disease in our study indicates that medical treatment (at least nine months of four combined antituberculous drugs) did not seem to be effective. If lymphadenopathy persists, total surgical excision of lymph nodes should be the treatment of choice.
探讨抗结核药物治疗结核性颈淋巴结炎（TCL）患者的疗效。
回顾1996年至2002年期间的73例TCL患者，并记录临床和实验室检查结果。研究了四联化疗方案的疗效。
58例（79%）患者的纯化蛋白衍生物（PPD）皮肤试验结果呈阳性。9例（12.3%）患者的胸部X线检查显示有与结核病相符的改变。药物治疗的平均持续时间为10.04个月。在随访评估中，14例（20%）患者被认为疑似耐药TCL，并对所有淋巴结进行了完全切除。组织病理学仅在其中10例病例中证实为结核病。
我们研究中残留疾病的高发生率表明，药物治疗（至少9个月的四种联合抗结核药物）似乎无效。如果淋巴结病持续存在，应选择手术完全切除淋巴结作为治疗方法。
