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结核性颈淋巴结炎患者脓肿形成所致皮肤瘘管的保守治疗

Conservative treatment for cutaneous fistula resulted from abscess formation in patients with tuberculous cervical lymphadenitis.

作者信息

Kim Bo Hae, Jeon Yung Jin, Jin Young Ju, Jeong Woo-Jin, Park Sung Joon, Ahn Soon-Hyun

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Auris Nasus Larynx. 2018 Oct;45(5):1061-1065. doi: 10.1016/j.anl.2018.01.006. Epub 2018 May 7.

Abstract

OBJECTIVE

This study describes the clinical characteristics and course of conservative treatment using anti-Tb medication and dressing in patients with tuberculous cervical fistula resulting from abscess formation, and to investigate factors prognostic of dressing and treatment duration.

METHODS

The medical records of patients with tuberculous cervical lymphadenitis were reviewed, and 38 of these patients who presented with cutaneous fistula that resulted from abscess formation were included in the study.

RESULTS

The mean duration of dressing until fistula closure was 3.7±2.0months (range 0.2-8.5), and the mean duration of treatment with anti-Tb medication was 10.6±2.6months (range 6.0-16.0). Patients with concomitant Tb, beyond the cervical lymph nodes showed significantly prolonged duration of dressing (4.6 months vs. 3.2 months, p=0.025) and anti-Tb medication (11.8 months vs. 9.8 months, p=0.015).

CONCLUSION

Our results indicate that about 3.7 months of dressing was required for fistula closure. Tuberculous cervical lymphadenitis patients with fistula who had Tb beyond the cervical lymph nodes could be expected to require dressing for 4.6 months and prolonged and anti-Tb medication treatment.

摘要

目的

本研究描述了因脓肿形成导致的结核性颈瘘患者使用抗结核药物和换药进行保守治疗的临床特征及过程,并探讨影响换药及治疗持续时间的预后因素。

方法

回顾了结核性颈淋巴结炎患者的病历,其中38例因脓肿形成出现皮肤瘘的患者纳入本研究。

结果

瘘管闭合前的平均换药时间为3.7±2.0个月(范围0.2 - 8.5个月),抗结核药物治疗的平均时间为10.6±2.6个月(范围6.0 - 16.0个月)。伴有颈部淋巴结以外结核的患者,换药时间(4.6个月对3.2个月,p = 0.025)和抗结核药物治疗时间(11.8个月对9.8个月,p = 0.015)显著延长。

结论

我们的结果表明,瘘管闭合大约需要3.7个月的换药时间。伴有颈部淋巴结以外结核的结核性颈淋巴结炎瘘管患者预计需要4.6个月的换药时间以及延长的抗结核药物治疗。

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