中国防痨杂志2023年6月第45卷第6期Chin J Antitubere.Jue2023,Vol.45.No.6·531··指南·规范·共识·浅表淋巴结结核的诊断与治疗专家共识中国人民解放军总医院第八医学中心结核病医学部《中国防痨杂志》编辑季委员会中国医疗保健国际交流促进会结核病防治分会【摘要】浅表淋巴结结核是最常见的肺外结核，因其临床症状缺乏特异性，与非结核性淋巴结炎、淋巴瘤、淋巴结转移癌等疾病鉴别困难。目前，浅表淋巴结结核治疗方式较多，主要包括全身化疗、局部治疗和中西医结合治疗等，而局部治疗又包括抗结核药物的局部注射，超声药物透入及病灶清除、切除等。因治疗方案各有优缺点，针对特定类型选用相应的治疗手段会取得更好的疗效。如何选取合理的治疗方案，我国尚缺乏相关指导性文件。为规范我国浅表淋巴结结核的诊断和治疗，提高临床医师对浅表淋巴结结核的诊治水平，使患者早日治愈，减少复发，中国人民解放军总医院第八医学中心，《中国防痨杂志》编辑委员会和中国医疗保健国际交流促进会结核病防治分会基础和临床学部联合组织专家，结合我国浅表淋巴结结核诊断及治疗的经验和方法，以及国外诊断和治疗相关研究成果，共同拟定《浅表淋巴结结核的诊断与治疗专家共识》。本共识概述了浅表淋巴结结核的流行病学特征、发病机制、病理生理特征和主要的临床表现，介绍了浅表淋巴结结核的常见检查方法，提出了诊断标准和需要鉴别诊断的疾病及预后，并根据疾病的不同临床分期及病理类型提出了治疗建议，以供临床医师对浅表淋巴结结核忠者进行精准诊断、合理治疗。【关键词】结核，淋巴结：诊断，鉴别；治疗应用；总结性报告（主题）【中图分类号】R522;R81Expert consensus on the diagnosis and treatment of superficial lymph node tuberculosis Senior Department ofTuberculosis,the Sth Medical Center of Chinese PLA General Hospital,Editorial Board of Chinese Journal ofAntituberculosis,Basic and Clinical Speciality Committees of Tuberulosis Control Branch of China International Exchangeand Promotive Asociation for Medical and Health CareCorresponding authors:Wang Tao,Email:wt19750728@hotmail.com:Wu Xueqiong,Email:xueqiongwu@139.com[Abstract]Superficial lymph node tuberculosis is the most common extrapulmonary tuberculosis.Due to thelack of specificity in its clinical symptoms,it is hard to differentiate it from non-tuberculous lymphadenitis,lymphoma,lymph node metastatic cancer,and other diseases.At present,there are many treatment methods forsuperficial lymphoid tuberculosis,mainly including systemic chemotherapy,local treatment,and integratedtreatment with traditional Chinese and western medicine,while local treatment includes local injection of anti-tuberculosis drugs,ultrasonic drug penetration,and focal clearance and resection.Due to the advantages anddisadvantages of each treatment scheme,it is better to choose appropriate treatment methods for specific types.How to select a reasonable treatment plan still lacks relevant guidance documents.Therefore,to standardize thediagnosis and treatment of superficial lymph node tuberculosis,and improve the level of clinicians to enable thepatients to recover early and reduce recurrence,the Eighth Medical Center of Chinese PLA General Hospital,theEditorial Board of the Chinese Journal of Antituberculosis,and the Basic and Clinical Speciality Committees of theTuberculsis Control Branch of China International Exchange and Promotive Association for Medical and HealthCare jointly organized experts to combine the experience and methods of diagnosis and treatment of superficial lymphnode tuberculosis in China,as well as research results related to diagnosis and treatment abroad,to formulate Expertconsensus on the diagnosis and treatment of superficial lymph node tuberculosis.This consensus outlines theepidemiology,pathogenesis,pathophysiological characteristics and main clinical manifestations of superficial lymphnode tuberculosis.It also introduces common examination methods,pu
