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耳鼻喉科实践中结核病的表现:在印度南部沿海城市进行的一项回顾性研究

Manifestations of Tuberculosis in Otorhinolaryngology Practice: A Retrospective Study Conducted in a Coastal City of South India.

作者信息

Sriram Rithika, Bhojwani Kiran M

机构信息

Kasturba Medical College, Light House Hill Road, Mangalore, Karnataka 575001 India.

Department of Otorhinolaryngology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka 575001 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Jun;69(2):210-215. doi: 10.1007/s12070-017-1079-4. Epub 2017 Feb 3.

Abstract

Tuberculosis (TB) of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world and is often misdiagnosed as cancer. To contribute to a better understanding of TB in the head and neck region by assessing its various manifestations, presentations, diagnostic techniques, risk factors, coexisting illnesses and treatment modalities. This was a retrospective study conducted over a 3 year period (2012-2014) in 2 hospitals in South India, among patients diagnosed to have TB of the head and neck. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi-square test was used to find association between the variables and  < 0.05 was considered statistically significant. Among 104 patients with TB of the head and neck, the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB, submandibular gland TB, deep neck space abscess and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB lymphadenitis. 26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Tuberculosis of head and neck is no longer uncommon. Pulmonary TB need not be associated nor is smoking a risk factor according to our study.

摘要

事实证明,头颈部结核对世界各地的耳鼻咽喉科医生来说都是一项诊断挑战,而且常常被误诊为癌症。通过评估头颈部结核的各种表现、症状、诊断技术、风险因素、并存疾病和治疗方式,以促进对头颈部结核的更好理解。这是一项在印度南部的两家医院进行的回顾性研究,研究对象为3年期间(2012 - 2014年)被诊断为头颈部结核的患者。使用半结构化表格从与研究的各个目标相关的病历中获取信息。使用SPSS 16.0版对数据进行分析,所得结果以百分比表示。采用卡方检验来发现变量之间的关联,P < 0.05被认为具有统计学意义。在104名头颈部结核患者中,最常见的表现是结核性淋巴结炎(86.53%),其次是喉结核、下颌下腺结核、颈部深部间隙脓肿和腺样体扁桃体结核。细针穿刺抽吸活检(FNAC)被发现是诊断结核性淋巴结炎的金标准。26%的患者合并感染艾滋病毒,16.3%的患者合并肺结核。超过20%的患者吸烟。大多数患者采用抗结核治疗。头颈部结核已不再罕见。根据我们的研究,肺结核不一定与之相关,吸烟也不是一个风险因素。

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