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中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (1): 53-56.doi: 10.3969/j.issn.1000-6621.2019.01.012

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颈部淋巴结结核发生结核性脓肿的危险因素分析

姚岚,肖和平()   

  1. 200433 同济大学附属上海市肺科医院结核科
  • 收稿日期:2018-05-06 出版日期:2019-01-10 发布日期:2019-01-09

Analysis of risk factors for tuberculous abscess in patients with tuberculous cervical lymphadenitis

Lan YAO,He-ping XIAO()   

  1. Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
  • Received:2018-05-06 Online:2019-01-10 Published:2019-01-09

摘要:

目的 探讨颈部淋巴结结核患者发生结核性脓肿的相关危险因素。方法 分析2013年7月至2016年6月于同济大学附属上海市肺科医院住院确诊的符合纳入标准的280例颈部淋巴结结核患者临床资料,分析颈部结核性淋巴结脓肿发生的危险因素。结果 280例颈部淋巴结结核患者中有52例(18.6%)患者在治疗中出现淋巴结脓肿、自行破溃或需要淋巴结切开引流。发生脓肿者中不规范治疗者占38.5%(20/52)、肿大淋巴结直径≥2cm者占76.9%(40/52)、年龄≤45岁者占90.4%(47/52);未发生脓肿者中不规范治疗者占24.6%(56/228)、肿大淋巴结直径≥2cm者占55.3%(126/228)、年龄≤45岁者占77.6%(177/228);差异均有统计学意义(χ2值分别为4.14、8.23、4.30,P值均<0.05)。多因素logistic回归分析显示,不规范治疗(OR=2.53,95%CI:1.31~4.89)、肿大淋巴结直径≥2cm(OR=2.29,95%CI:1.12~4.66)和年龄≤45岁(OR=3.68,95%CI:1.21~11.17)为发生颈部结核性淋巴结脓肿的危险因素。结论颈部淋巴结结核患者治疗不规范、肿大淋巴结直径≥2cm及年龄≤45岁为发生结核性脓肿的独立危险因素,当颈部淋巴结结核患者出现上述危险因素时要警惕发生结核性脓肿的可能。

关键词: 结核, 淋巴结, 脓肿, 危险因素, 数据说明, 统计

Abstract:

Objective To investigate the risk factors for tuberculous abscess in patients with tuberculous cervical lymphadenitis. Methods We collected the clinical data of 280 patients who were admitted to and diagnosed with tuberculous cervical lymphadenitis in Shanghai Pulmonary Hospital affiliated to Tongji University from July 2013 to June 2016 and met the inclusion criteria of this study. Then we prospectively analyzed the risk factors of tuberculous abscess in cervical lymph node. Results Of the 280 patients with tuberculous cervical lymphadenitis, 52 cases (18.6%) formed tuberculous abscess that could spontaneously rupture or needed drainage of lymph nodes. Among the patients with abscess, 38.5% (20/52) received irregular treatment, 76.9% (40/52) had lymph nodes ≥2 cm, and 90.4% (47/52) were aged ≤45 years old; among the patients without abscess, 24.6% (56/228) cases received irregular treatment, 55.3% (126/228) had lymph nodes ≥2 cm, and 77.6% (177/228) were aged ≤45 years old. The differences between the two groups were statistically significant (χ2 values were 4.14, 8.23, and 4.30, respectively, P values were <0.05). Multivariate logistic regression analysis showed that irregular treatment (OR=2.53,95%CI: 1.31-4.89), lymph nodes ≥2 cm (OR=2.29, 95%CI: 1.12-4.66) and age ≤45 years old (OR=3.68, 95%CI: 1.21-11.17) were independent risk factors for tuberculous abscess. Conclusion The irregular treatment, lymph nodes ≥2 cm and age ≤45 years old are independent risk factors for tuberculous abscess in patients with tuberculous cervical lymphadenitis. Be alert to the possibility of tuberculous abscess when these risk factors are present in patients with tuberculous cervical lymphadenitis.

Key words: Tuberculosis, lymph node, Abscess, Risk factors, Data interpretation, statistical