601例颈部肿块的临床病例分析

汪李琴 周涵 史雅文

[摘要] 目的 回顧性分析颈部肿块临床病例资料，以提高对颈部肿块的诊疗水平。 方法 收集南京医科大学第一附属医院耳鼻咽喉科2010年1月至2018年12月期间收治住院的601例颈部肿块患者资料，分析疾病的发病规律、影像学特点和病理结果。 结果 根据术后病理，分为甲状腺疾病组98例（16.3%）和非甲状腺疾病组;非甲状腺组又分为炎性包块组75例（12.5%），先天性疾病组205例（34.1%），良性肿瘤组74例（12.3%）和恶性肿瘤组149例（24.8%）。甲状腺疾病中女患者多于男患者，而颈部恶性肿瘤中男患者多于女患者，差异有统计学意义（P<0.05）;不同疾病年龄差异有统计学意义（P<0.05），先天性疾病组年龄低于甲状腺疾病、炎性包块、良性肿瘤和恶性肿瘤组（P<0.05）;恶性肿瘤组年龄高于甲状腺疾病、炎性包块、良性肿瘤组（P<0.05）。不同疾病病程差异有统计学意义（P<0.05），炎性包块的病程短于先天性疾病、良性肿瘤、恶性肿瘤（P<0.05）;而颈部非甲状腺肿瘤，恶性肿瘤的病程短于良性肿瘤，差异有统计学意义（P<0.05）。 结论 颈部肿块病理类型多样，临床及影像学表现多变，应掌握其各项特征，以提高常见疾病及罕见病的确诊率及诊疗水平。

[关键词] 颈部肿块;肿瘤;先天性疾病;甲状腺疾病;炎性包块

[中图分类号] R445.2          [文献标识码] B          [文章编号] 1673-9701（2021）36-0092-05

Clinical analysis of 601 cases of the cervical mass

WANG Liqin   ZHOU Han   SHI Yawen

Department of Otorhinolaryngology， the First Affiliated Hospital of Nanjing Medical University， Nanjing   210029， China

[Abstract] Objective To retrospectively analyze the clinical data of cervical mass to improve the diagnosis and treatment of cervical mass. Methods The data of 601 patients with cervical mass admitted to the Department of Otorhinolaryngology in the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2018 were collected. The pathogenesis regularity， imaging characteristics， and pathological results of the disease were analyzed. Results According to postoperative pathology， the patients were divided into thyroid disease group （n=98） and non-thyroid disease group（n=503）. The non-thyroid disease group was divided into the inflammatory mass group （n=75， 12.5%）， the congenital disease group （n=205， 34.1%）， benign tumor group （n=74， 12.3%） and malignant tumor group （n=149， 24.8%）. There were more female patients than males in thyroid diseases， while there were more male patients than females in cervical malignancies， and the difference was statistically significant （P<0.05）. There were significant differences in the age of different diseases（P<0.05）. The age of the congenital disease group was lower than that of thyroid disease， inflammatory mass， benign tumor， and malignant tumor groups（P<0.05）， and the age of the malignant tumor group was higher than that of thyroid disease， inflammatory mass， and benign tumor groups （P<0.05）. There were significant differences in the course of different diseases（P<0.05）. The course of inflammatory mass was significantly lower than that of congenital diseases， benign tumors， and malignant tumors （P<0.05）. However， in cervical non-thyroid tumors， the course of malignant tumors was significantly different from that of benign tumors （P<0.05）. Conclusion The pathological types， clinical and imaging manifestations of cervical mass are diverse. The characteristics should be mastered to improve the diagnosis rate and the level of diagnosis and treatment of common diseases and rare diseases.

[Key words] Cervical mass; Tumor; Congenital disease; Thyroid disease; Inflammatory

颈部肿块是位于下颌骨以下、锁骨以上的肿块，多见于颈正中部、侧颈部及锁骨上等，通常于无意间发现（肉眼可见、触及或影像学检查发现），是耳鼻咽喉头颈外科中常见的疾病之一[1]。颈部肿块的病因复杂，病理类型众多，可由先天性疾病、外伤、感染性疾病、良性或恶性肿瘤引起[2-3]。……