目的 总结56例卡介苗所致淋巴结强反应的临床表现, 评价局部治疗效果。方法 收集2010年1月-2014年5月结核病门诊56例由卡介苗所致淋巴结强反应患儿, 根据其临床表现, 分别给予热敷、清创引流及敷药等局部治疗, 并分析疗效。结果 1)分型结节未液化型7例, 液化型20例, 脓肿破溃型23型, 术后伤口未愈者6例。2)疗效7例未液化型经局部热敷, 5例结节缩小, 2例结节液化;22(20+2)例液化型经穿刺针吸及结节内注射异烟肼, 均化脓破溃;45(23+22)例脓肿破溃型经清创引流, 利福平外敷, 伤口愈合;6例手术后伤口未愈者经清创引流、利福平外敷, 伤口愈合。结论 新生儿接种卡介苗所致淋巴结强反应临床表现多样, 局部治疗效果好。

Objective To analyze the clinical features and evaluate the local treatment effect among 56 neonatal cases with strong lymph reactions caused by Bacille Calmette Guerin (BCG) vaccination. Methods A total of 56 neonatal cases with strong lymph node reactions caused by BCG vaccination were collected from tuberculosis clinic from January 2010 to May 2014, whose clinical features were analyzed.The treatment effects were evaluated after given hot pack, needle aspiration, debridement and antituberculous drugs according to their different lesion types. Results 1) Lesion typeThe lesions of the 56 cases were classified into node without liquefaction (7 cases), liquefaction (20 cases), abscess rupture (23 cases), unhealed after surgery (6 cases).2)Treatment effectsamong 7 cases without liquefaction, 5 cases' lymph node shrunk and 2 cases' lesion liquefied after hot pack treatment;Liquefaction lesions of 22 (20+2) cases were turned into abscess rupture after treatments of local aspiration and nodule injection of isoniazid (INH) combined with hot pack; abscess rupture lesions of 45 (23+22) cases were healed after given debridement, wound drainage with INH, pack with rifampicin (RFP); 6 surgery unhealed cases were healed after treatments with debridement, wound drainage with INH and RFP pack. Conclusion There are multiple clinical features of strong lymph node reaction caused by BCG vaccination among neonatal cases, and the local treatments given in this study would get high cure rate.