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頸部淋巴腺結核의 外科的 考察

A Clinical Study on the Cervical Tuberculous Lymphadenitis

대한외과학회지 1968년 10권 2호 p.85 ~ 90
선우영,
소속 상세정보
선우영 (  ) - 서울대학교 의과대학 외과학교실

Abstract


The author reports a clinical study of 322 cases in which cervical tuberculous lymphadenitis was suspected clinically in the Seoul National University Hospital and the Seoul Red Cross Hospital from June 1964 to June 1966.
Of a total of 322 casea 225 were diagnosed definitely as tuberculous lymphadenitis, of which 85 were confirmrd by biopsy, 140 by local findings, aspiration or operative findings, and the remaining 97 were 55 of undetermined and 42 of other disease.
The result are as follows:
1) In the series, females predominated otrer males by about 1.6:1. The highest incidence was from 21 to 30 yrs with. 40.4 %
2) Duration of symptom was most frequent from 2 to 6 months, and systemic symptoms including mild fever, general malaise, loss of weight and slight pain in the cervical mass were present only in 52 cases (23.1%)
3) In local findings, mass only was present in 72.4%, cold abscess with mass in 12% and fistula or sinus in 15.6%.
4) In size of the mass, either solitary or conglomerated. chest-nut size showed a peak incidence with 32.9% , while bean-size was 28%, egg-size 20.5%, ad fistsize or more 18.6%,
5) In order of frequency of location of the lymphadenopathy, 33% of the cases was found in deep cervical lymphnode, 17.3% in submaxillary lymphnode, 14.2% in superficial. lymphnode, 9.75 in suprac lavicular node and 6.2% in axillary node, and 153 cases (68%) were unilateral, 72 cases (32%) bilateral.
6) Of 127 cases in which operative biopsies were performed, 85 (67%) were tuberculosis, 24 (19%) were non-specific lymphadenitis.
7) Of cases in which chest X-ray was checked. only 34 cases (30.3%) showed active pulm tbc., 78 cases(69.7%) were negative.
8) Of cases in which tuberculin skin test were done, 12 cases (60%) were positive and 8 cases (40%) were negative. and there was no correlation between the results of the test and X-ray or biopsy findings.
9) Of 225 cases treated, operative intervention was reported in 103 cases. of which 47 cases were treated with I & D, simple incision. and curettage or fistulectomy, 59 cases with radical extirpation. Local infusion of antibiotics was carried out in 37 cases. Anti-tuberculosis and other supportive treatment were added to all these cases. And the rest of the cases (85) was treated wiht anti-tbc. theraphy only.
10) The rate of recurrruence was 34% in simple I & D, 10.7% in radical extirpaticn, 30% in local infusion but the recurrences were cured by additional surgical intervention.

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