Campbell I A, Dyson A J
Tubercle. 1977 Dec;58(4):171-9. doi: 10.1016/0041-3879(77)90041-1.
The treatment of lymph node tuberculosis has been studied in 108 patients. Chemotherapy consisted of 18 months' isoniazid with either rifampicin or ethambutol, plus an initial supplement of streptomycin. These 2 regimens were randomly allocated to 19 patients who had previously undergone excision of the lymph nodes, 56 patients who had undergone biopsy and 33 patients who had not had any surgical procedures. The majority of patients were of Indian or Pakistani origin (80%). Histological evidence of tuberculosis was obtained in 64% of the 108 patients and M. tuberculosis was cultured in 30%. No other mycobacteria were grown. Progress during treatment was uneventful in 65% of patients. Fresh nodes appeared during treatment in 12%, existing nodes enlarged in 13% and fluctuation developed in 11% of patients. Discharge and/or sinus formation was infrequent (7%), as was breakdown of a surgical scar (4%). Excision or aspiration after the start of chemotherapy was performed in 19% of patients. In the period up to the end of chemotherapy no difference emerged between the patients who received rifampicin with isoniazid and those who received ethambutol with isoniazid. Satisfactory results were obtained in 98% of the patients by the end of treatment although 13% still had slight node enlargement. The place of surgery is discussed. Follow-up will continue for 18 months after the end of chemotherapy.
对108例淋巴结结核患者的治疗进行了研究。化疗方案为异烟肼治疗18个月，联合利福平或乙胺丁醇，并初始加用链霉素。这两种方案被随机分配给19例此前已行淋巴结切除术的患者、56例已接受活检的患者以及33例未接受任何外科手术的患者。大多数患者为印度或巴基斯坦裔（80%）。108例患者中64%有结核的组织学证据，30%培养出结核分枝杆菌。未培养出其他分枝杆菌。65%的患者治疗过程顺利。12%的患者在治疗期间出现新的淋巴结，13%的患者现有淋巴结肿大，11%的患者出现波动感。引流和/或窦道形成不常见（7%），手术瘢痕破溃也不常见（4%）。19%的患者在化疗开始后进行了切除或抽吸。在化疗结束前，接受异烟肼联合利福平的患者与接受异烟肼联合乙胺丁醇的患者之间未出现差异。治疗结束时98%的患者取得了满意的结果，尽管13%的患者仍有轻微的淋巴结肿大。文中讨论了手术的作用。化疗结束后将继续随访18个月。
