本文關(guān)鍵詞： 非霍奇金淋巴瘤 咽喉部 臨床 診斷　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討咽喉部非霍奇金淋巴瘤(NHL)的發(fā)病情況、臨床特點、診斷要點及誤診原因,為臨床醫(yī)師對該病的早期診斷及治療提供一定的經(jīng)驗及臨床依據(jù)。方法對2012年~2016年3月我院收治的23例咽喉部非霍奇金淋巴瘤患者的完整的臨床資料作回顧性分析。結(jié)果男:女=1:1.3。平均年齡56.96歲。平均病程3.83個月。B細胞來源20例,占86.96%,T細胞來源3例,占13.04%。臨床表現(xiàn)主要為咽痛、咽異物感,15例,占65.22%,其次為頸部包塊,5例,占21.74%。發(fā)病部位主要為扁桃體,17例(73.91%),鼻咽部3例(13.04%),舌根3例(13.04%)。A組20例,B組3例。其中17例(73.91%)有多次就診經(jīng)歷,6例(26.09%)經(jīng)多次活檢確診。4例予化療,2例達部分緩解(PR),2例達穩(wěn)定(SD);1例予放療+化療,腫瘤達完全緩解(CR)。3例予以手術(shù)切除病變。結(jié)論咽喉部非霍奇金淋巴瘤表現(xiàn)無特異性,早期表現(xiàn)易與咽喉部炎癥等相混淆,詳盡的病史詢問、體格檢查、實驗室檢查及影像學(xué)檢查對診斷及鑒別診斷有參考價值,但誤診及漏診率仍較高,故應(yīng)引起重視,采取措施,以提高早期診斷及治療水平。其治療方案主要為放療、化療或放化療聯(lián)合,可收到較好的臨床效果,是否需聯(lián)合手術(shù)治療尚無定論。
[Abstract]:Objective to investigate the incidence, clinical features, diagnosis and misdiagnosis of non-Hodgkin 's lymphoma in pharynx and larynx. Methods from 2012 to March 2016, 23 patients with non-Hodgkin 's lymphoma of pharynx and larynx were treated in our hospital. Retrospective analysis of bed data. Results male:. The mean age was 56.96 years. The mean course of disease was 3.83 months. The main clinical manifestations were pharynx pain, foreign body sensation of pharynx in 15 cases (65.22%), and neck mass in 5 cases. The main site of the disease was tonsil in 17 cases (73.91), nasopharynx in 3 cases (13. 04), tongue root in 3 cases (13. 04) and group A (20). Group B (3 cases, including 17 cases (73.91)), 6 cases (26.09) confirmed by multiple biopsies, 4 cases were given chemotherapy and 2 cases had partial remission (PRR). 2 cases reached stable SDN; One case was treated with radiotherapy and chemotherapy, and 3 cases with complete tumor remission were resected by operation. Conclusion there is no specificity in laryngeal non-Hodgkin 's lymphoma, and the early manifestations are easily confused with pharyngopharyngeal inflammation. Detailed medical history examination, physical examination, laboratory examination and imaging examination have reference value for diagnosis and differential diagnosis, but the rate of misdiagnosis and missed diagnosis is still high. Therefore, attention should be paid to it and measures should be taken. In order to improve the level of early diagnosis and treatment, the main treatment regimen is radiotherapy, chemotherapy or combination of radiotherapy and chemotherapy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.6

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