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目的:探讨小儿接种卡介苗后发生卡介苗性淋巴结反应的病因及诊断方法。方法:对231例出现卡介苗性淋巴结反应患儿的临床特征及诊断进行总结和分析。结果:①患儿均有新生儿BCG接种史;②无结核病接触史,接种后发生局部淋巴结病变,符合原发感染;③无结核中毒症状及其他部位结核病;④PPD(+~++);⑤病变淋巴结病理学检查结果符合淋巴结结核的病理改变。结论:小儿腋下淋巴结出现结核样改变时,应考虑卡介苗性淋巴结反应;若诊断成立,可行外科手术治疗,对术后病理证实为淋巴结结核者无需特殊治疗。
Objective: To investigate the etiology and diagnosis of BCG-resistant lymph node reaction in children after BCG vaccination. Methods: The clinical features and diagnosis of 231 cases of BCG-responsive lymph node reaction were summarized and analyzed. Results ① There was a history of neonatal BCG vaccination in both infants and children. ②No history of contact with tuberculosis was found. Local lymph node disease occurred after inoculation, which was consistent with primary infection. ③Non-TB poisoning symptoms and other parts of tuberculosis; ④PPD (+ ~ ++) The pathological findings of diseased lymph nodes are in line with the pathological changes of lymph node tuberculosis. CONCLUSION: BCG-like lymph node reaction should be considered in the case of tuberculosis-like changes in pediatric axillary lymph nodes. If the diagnosis is established, surgical treatment is feasible and there is no need for special treatment for postoperative pathology confirmed as lymph node tuberculosis.