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[播散性破坏性肺结核外科治疗中纵隔淋巴结清扫术的临床形态学依据]

[Clinicomorphological rationale for mediastinal lymphadenectomy in the surgical treatment of disseminated destructive pulmonary tuberculosis].

作者信息

Giller D B, Papkov A V, Gedymin L E, Sigaev A T, Sadovnikova S S, Bizhanov A B, Gavrilova S A, Volynkin A V, Giller G V

出版信息

Probl Tuberk Bolezn Legk. 2008(10):21-5.

Abstract

The paper analyzes morphological changes and results of surgical treatment in 515 patients with destructive pulmonary tuberculosis. Two hundred and seventy-four patients underwent mediastinal lymphadenectomy and in 241 patients lung resections or pneumonectomies were not followed by lymphadenectomy or solitary caseous molten lymph nodes were removed during an operation. In disseminated destructive pulmonary tuberculosis, active tuberculosis of intrathoracic lymph nodes (ILN) was found in 97%. The latter's significant signs are an enlarged lymph node of more than 2.0 cm, consolidation, periadenitis, and fluctuation. The incidence, extent, and pattern of ILN lesion varied in a lung tuberculous process depending on its site, form, and inflammation phase.

摘要

本文分析了515例毁损型肺结核患者的形态学变化及外科治疗结果。274例患者接受了纵隔淋巴结切除术,241例患者在肺切除或全肺切除术后未进行淋巴结切除术,或在手术中切除了孤立的干酪样液化淋巴结。在播散性毁损型肺结核中,97%发现有胸内淋巴结(ILN)活动性结核。后者的显著体征为淋巴结肿大超过2.0 cm、实变、淋巴结周炎及波动感。ILN病变的发生率、范围及模式在肺结核过程中因病变部位、形态及炎症阶段而异。

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