LNR颈部淋巴结结核外科临床分期系统构建与应用.docVIP

LNR颈部淋巴结结核外科临床分期系统构建与应用 　　[摘要] 目的 构建一种新型颈部淋巴结结核外科临床分期系统并检验其对疗效和并发症的预测价值。 方法 收集179例2013年1月～2015年7月在陕西省结核病防治院接受外科治疗的颈部淋巴结结核患者资料，包括年龄、体重指数、病灶大小、受累淋巴结区域、耐多药情况以及糖尿病情况，筛选出影响疗效和并发症的危险因素，根据这些危险因素进行外科临床分期。 结果 病灶直径≥3 cm、淋巴结受累≥2组及耐多药（+）是影响外科治疗效果的危险因素，以病灶（Lesion，L）、淋巴结（Node，N）、耐多药（Resistence，R）这3种因素构建LNR外科临床分期系统，共分为3期，各分期之间并发症发生率差异有统计学意义（P 0.05）。 结论 新型外科临床分期系统对颈部淋巴结结核疗效和并发症有较好的预测价值和指导意义。 　　[关键词] 颈部淋巴结结核；分期系统；并发症 　　[中图分类号] R522 [文献标识码] A [文章编号] 1673-7210（2016）01（c）-0031-04 　　Building and application of LNR surgical staging system in cervical tuberculous lymphadenitis 　　WANG Zhi LI Junxiao HUO Xuee XU Junli ZHAO Tao CUI Yuanbo YAO Linming CHEN Qiliang▲ 　　Department of Surgery， Tuberculosis Hospital of Shaanxi Province， Shaanxi Province， Xian 710100， China 　　[Abstract] Objective To build a new type of surgical staging system and verify the predictive value and curative effect in patients with cervical tuberculosis lymphadenitis. Methods Medical records of 179 cervical tuberculosis lymphadenitis patients who underwent surgical treatment from January 2013 to July 2015 in Tuberculosis Hospital of Shaanxi Province were reviewed. The data of age， body mass index， lesion size， nodal involvement area， whether complicated with diabetes as well as the existence of multidrug-resistant were analyzed to screen the risk factors which affected curative effect and complications. According to these risk factors， the surgical staging system was built. Results The lesion diameter ≥3 cm， lymph node involvement ≥2 areas and multidrug-resistant positive were risk factors which significantly increased the occurrence of postoperative complications. The LNR surgical staging system based on lesion （L）， node （N） and resistence （R） was divided into three stages. The incidences of complication had statistically significant differences among each stage （P 0.05）. Conclusion The new surgical clinical staging system for cervical tuberculous lymphadenitis has good predictive value for complications and