Lekhbal Adil, Chaker Kaoutar, Halily Sara, Abada Reda Lah, Rouadi Sami, Roubal Mohamed, Mahtar Mohamed
ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Centre IBN ROCHD, Casablanca, Morocco.
Ann Med Surg (Lond). 2020 May 18;55:159-163. doi: 10.1016/j.amsu.2020.05.006. eCollection 2020 Jul.
lymph node tuberculosis is the most common form of extra pulmonary tuberculosis. Although diagnosis is usually difficult, therapeutic management remains a challenge and a subject of national and international debate.
the medical records of patients with cervical lymph node tuberculosis who were treated at 20 August Hospital, Casablanca, Morocco, between May 2017 and November 2018 were reviewed. The results of the treatment were analyzed retrospectively.The aim of our work was to identify all causes of medical treatment failure in cervical lymph node tuberculosis, and to propose indications for the use of surgery in cervical lymph node tuberculosis in Morocco.
Out of a total of 104 patients, the mean age was 24 years, the sex ratio was 0.51 (women: 66.3%), twenty (19.2%) patients received medical treatment alone, and 84 (80.8%) patients required medical and surgical treatment. Surgery was required when the size of the lymphadenopathies was greater than or equal to 3 cm (p = 0.005), when the patient presented with an abscess and/or fistula(p = 0.005), when the patient presented with resistance to antibacillary drugs(p = 0.032), or developed a paradoxical upgrading reactions (p = 0.001), or when the patient had a recurrence of lymph node tuberculosis(p = 0.008) on multivariate analysis.
antibiotic therapy remains the main treatment for all patients in lymph node tuberculosis, but the results of our work show the value of surgery in some indications.
淋巴结结核是肺外结核最常见的形式。尽管诊断通常困难，但治疗管理仍然是一项挑战，也是国内和国际争论的主题。
回顾了2017年5月至2018年11月在摩洛哥卡萨布兰卡20日医院接受治疗的颈淋巴结结核患者的病历。对治疗结果进行回顾性分析。我们工作的目的是确定颈淋巴结结核治疗失败的所有原因，并提出摩洛哥颈淋巴结结核手术治疗的指征。
在总共104例患者中，平均年龄为24岁，性别比为0.51（女性：66.3%），20例（19.2%）患者仅接受药物治疗，84例（80.8%）患者需要药物和手术治疗。多因素分析显示，当淋巴结肿大大小大于或等于3 cm（p = 0.005）、患者出现脓肿和/或瘘管（p = 0.005）、患者对抗结核药物耐药（p = 0.032）、出现矛盾性加剧反应（p = 0.001）或淋巴结结核复发（p = 0.008）时，需要进行手术。
抗生素治疗仍然是所有淋巴结结核患者的主要治疗方法，但我们的工作结果显示了手术在某些指征下的价值。
