卡介苗接种后淋巴结强反应66例临床分析

目的探讨婴幼儿卡介苗接种后引起淋巴结强反应的原因及处理。方法2003年2月～2007年2月间,我所门诊收治的接种卡介苗后淋巴结强反应的婴幼儿。患儿均给予局部治疗和预防性抗结核治疗,口服异烟肼10mg/(kg·d)1次/d,利福喷丁7mg/(kg·d)1次/2d,结核灵<1岁1/2片3次/d,>1岁1～2片3次/d,超强反应者加用吡嗪酰胺20mg(kg.d)分3次/d,连服3～4个月。结果66例患者中3个月以内发生占68.18%(45/66),4～8个月占31.82%(21/66),发生部位左侧腋下占75.76%(50/66),左颈部占10.60%(7/66),左锁骨上、下占13.64%(9/66),单发占69.70%(46/66),多发占30.30%(20/66),干酪型占86.36%(57/66),脓肿型13.64%(9/66),病例经过在治疗15～80天后淋巴结逐渐缩小、痊愈,治愈率100%。结论提高卡介苗接种技术、接种质量和及时正确处理BCG接种后的强反应是防止减少卡介苗接种引起淋巴结强反应和影响治愈的关键措施。

The clinical analysis of 66 cases' lymph nodes strong responses after BCG vaccination

Objective Probe into the causes and disposals of the strong responses on 66 nurslings after BCG vaccination.Methods during Feb.2003 and Feb.2007,the nurslings received in our outpatient department are all given local and prophylactic antiphthisis treatment.They are taught to orally take Isoniazid,Rifapentine as well as Jiehelingpian properly,and those whose response is ultra strong,we add Pyrazinamide to them.All the drugs are needed to be taken continuously for 3-4 months.Results 45 nurslings out of 66 response in 3 months(68.18%),21 in 4-8 months(31.82%) and 75.76% of them have reaction in left oxter,10.60% in left cervix and 13.64% around left collarbone.46 of them only response on single lymph nodes(69.70%),while the rest have multiple responses(30.30%).Majority is cheesy type(86.36%) and minority is apothegmatic(13.64%).After treating for 15-80 days,the responses are weakened and gradually disappear.The curative ratio is 100%.Conclusion the technique and the quality of BCG vaccination as well as rightly disposal is the key measure to prevent the lymph nodes strong responses after vaccination and improve the curative ratio.