[韦格纳肉芽肿的头颈部表现及治疗]
[Head and neck manifestations and management of Wegener's granulomatosis].
作者信息
Li Qingming, Zhang Baoquan, Peng Peihong, Gao Zhiqiang, Yin Haijin, Feng Guodong
机构信息
Department of Otorhinolaryngology, Peking Union Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
出版信息
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2005 Dec;19(24):1112-5.
OBJECTIVE
To explore the characteristic and management of Wegener's granulomatosis in head and neck.
METHOD
Forty-two cases with Wegener's granulomatosis were retrospectively analyzed clinical characteristics, head and neck manifestations, biopsy, ANCA test, and management were respectively recorded. Cyclophosphamide and Prednisone are the mainstay of medical therapy.
RESULT
All cases presented with multiple organ systems involvement. Nasal involvement occurred most in head and neck, the occurred rate was 81.0%, the rate of first-occurred signs and symptoms was 47.6%. The diagnosis rate by biopsy was 67.6%. The total positive rate of ANCA test was 97.4%.
CONCLUSION
Head and neck involvement in Wegener's granulomatosis is most common and complicated. ANCA test and biopsy are the most main means in the diagnosis of Wegener's granulomatosis. Medical therapy is the mainstay of treatment in Wegener's granulomatosis, whereas surgery is reserved for selected head and neck manifestations.
目的
探讨韦格纳肉芽肿累及头颈部的特点及治疗方法。
方法
回顾性分析42例韦格纳肉芽肿患者的临床特征，记录头颈部表现、活检、抗中性粒细胞胞浆抗体（ANCA）检测及治疗情况。环磷酰胺和泼尼松是主要的药物治疗手段。
结果
所有病例均有多系统受累。头颈部受累以鼻部最为常见，发生率为81.0%，首发症状发生率为47.6%。活检诊断率为67.6%。ANCA检测总阳性率为97.4%。
结论
韦格纳肉芽肿累及头颈部最为常见且复杂。ANCA检测和活检是诊断韦格纳肉芽肿的主要手段。药物治疗是韦格纳肉芽肿的主要治疗方法，而手术仅适用于特定的头颈部表现。
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