Abstract:

Objective To explore the surgical effect of cervical lymph node tuberculosis patients at different imaging stages, in order to find the most suitable stage for surgical treatment. Methods A total of 201 cervical lymph node tuberculosis patients admitted to Xi ’an Chest Hospital and confirmed by pathology were collected from Xi’an Chest Hospital between January 2019 and January 2021. According to results of neck enhanced CT, patients were divided into 4 groups of different stages, which were stage Ⅰ group (nodular type, n=48), stage Ⅱ group (infiltrative type, n=62), stage Ⅲ group (abscess type, n=56), stage Ⅳ group (ulcerative type or ulcerative fistula type, n=35). The final length of scar, the healing time and the recurrence rate of cervical lymph node tuberculosis after wound healing in these 4 groups were observed. Results The wound healing time, the length of scar and the recurrence rate in stage Ⅰ group were 5.00 (5.00, 5.00) d, (3.79±0.53) cm and 10.4% (5/48); 10.00 (8.75, 12.00) d, (4.43±0.44) cm and 11.3% (7/62) in stage Ⅱ group, 16.00 (12.25, 19.75) d, (5.09±0.65) cm and 26.8% (15/56) in stage Ⅲ group, 19.00 (16.00, 22.00) d, (4.86±0.51) cm and 28.6% (10/35) in stage Ⅳ group. Comparison of the 4 groups showed that the postoperative healing time in stageⅡgroup was higher than that in stage Ⅰ group, the postoperative healing time in stage Ⅲ group was higher than that in stage Ⅱ group, and the postoperative healing time in stage Ⅳ group was higher than that in stage Ⅲ group, all the differences were statistically significant (Z=152.435, P<0.001), the scar length in stage Ⅱ group was longer than that in stage Ⅰ group, the scar length in stage Ⅲ group was longer than that in stage Ⅱ group, both the differences were statistically significant (F=55.887, P<0.001). The recurrence rates after postoperative healing in stage Ⅲ and stage Ⅳ groups were significantly higher than those in stageⅠand stage Ⅱ groups (χ²=9.165, P=0.027). Conclusion Of the cervical lymph node tuberculosis, the wound healing time, the length of scar and the recurrence rate increased as the stage progressed. Therefore, surgical treatment was recommended to perform as soon as possible for cervical lymph node tuberculosis patients whose lesion did not change after drug treatment.

Key words: Surgery, Tuberculosis,lymph node, Neck, Radiographic image enhancement, Comparative effectiveness research