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目的：通过14例颌面部淋巴结猫抓病的临床分析,对该病的临床表现、诊断和鉴别诊断进行归纳,以减少临床误诊率。方法：收集1974～2005年经病理确诊的14例颌面部淋巴结猫抓病病例,作回顾性分析。结果：本组14例中有被猫舔、咬或抓伤史12例。病变发生在腮腺淋巴结4例(28．57%),颌下淋巴洁5例(35．71%),颏下区淋巴结3例,上颈部淋巴结2例。术前诊断为淋巴结猫抓病4例,腮腺混合瘤3例,颌颈部淋巴结炎5例,颈淋巴结结核2例。病变淋巴结行手术切除,并送病理检查,伤口一期愈合。病理诊断均为淋巴结猫抓病。本组病例的最后诊断与初诊的符合率只有28．57%,而误诊率达71．43%。结论：淋巴结猫抓病为自限性、与猫直接接触性传染病,但人与人之间不传播。其诊断主要依据有与猫的接触史及淋巴结内抽出无菌性脓液,或猫抓病抗原皮试阳性,或淋巴结活检符合猫抓病。治疗主要是预防继发感染,不要玩猫是最好的预防措施。
OBJECTIVE: To summarize the clinical manifestations, diagnosis and differential diagnosis of maxillofacial lymph node dissection in fourteen cases, in order to reduce the clinical misdiagnosis rate. Methods: Fourteen cases of pathologically diagnosed maxillofacial lymph node cat scratch disease were collected from 1974 to 2005 for retrospective analysis. Results: There were 12 cases of cat licking, bite or scratching in this group of 14 cases. The lesions occurred in 4 cases (28.57%) of parotid lymph nodes, 5 cases of submandibular lymph node dissection (35.71%), 3 cases of submental area lymph nodes and 2 cases of upper cervical lymph nodes. Preoperative diagnosis of lymph node cat scratch disease in 4 cases, parotid mixed tumor in 3 cases, 5 cases of maxillofacial lymphadenitis, cervical lymph node tuberculosis in 2 cases. Lymph nodes were surgically removed and sent for pathological examination, wound healing. Pathological diagnosis of lymph node cat scratch disease. The final diagnosis of this group of patients with the initial diagnosis of coincidence rate of only 28.57%, while the misdiagnosis rate of 71.43%. Conclusion: Lymph node cat scratch disease is self-limited, and cats directly contact with sexually transmitted diseases, but not between people. The diagnosis is mainly based on the history of contact with the cat and the extraction of aseptic pus within the lymph node, or cat scratch antigen skin test positive, or lymph node biopsy consistent cat scratch disease. Treatment is mainly to prevent secondary infection, do not play cats is the best preventive measures.