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目的:探讨Wegener肉芽肿病(WG)在耳鼻咽喉-头颈部的临床表现及处理方法。方法:回顾性分析42例WG患者的临床资料,分别对其临床特征、炼茄屎愍餐肪蓖饪票硐帧⒒罴旒翱怪行粤O赴赴士固澹?NCA)检测及治疗方法进行记录分析。治疗主要采用环磷酰胺加泼尼松联合应用的内科治疗。结果:全部病例均呈现多系统、多器官受累,34例(81.0%)以鼻部受累为最明显,32例(76.2%)肺受累。首发症状以鼻部为首位20例(47.6%),其次发热11例(26.2%)。37例行活检,其中25例确诊,确诊率为67.6%。ANCA检测总阳性率为97.4%。结论:WG在耳鼻咽喉-头颈部表现复杂多变,ANCA检测和活检是诊断的主要手段。主要以内科治疗为主,手术治疗是有选择性的。
Objective: To investigate the clinical manifestations and treatment of Wegener’s granulomatosis (WG) in otolaryngology-head and neck. Methods: The clinical data of 42 patients with WG were retrospectively analyzed. The clinical features of the patients with WG were retrospectively analyzed. The results were as follows: And treatment methods for record analysis. Treatment is mainly used cyclophosphamide plus prednisone combined with medical treatment. Results: All the cases showed multi-system and multi-organ involvement. The nasal involvement was the most obvious in 34 cases (81.0%) and the lung involvement in 32 cases (76.2%). The first symptom of nosocomial infection in 20 cases (47.6%), followed by fever in 11 cases (26.2%). 37 routine biopsy, of which 25 cases were diagnosed, the diagnosis rate was 67.6%. The total positive rate of ANCA was 97.4%. Conclusion: The performance of WG in the otolaryngology - head and neck is complex and variable. ANCA and biopsy are the main means of diagnosis. The main medical treatment, surgical treatment is selective.