艾滋病与卡波氏肉瘤

艾滋病是人类免疫缺陷病毒引起的一种获得性免疫缺陷综合征。HIV病毒进入人体后 ,侵入体内各种细胞 ,最主要的靶细胞是 T4 淋巴细胞 ,当 T4 淋巴细胞减少 ,人体免疫系统严重破坏 ,产生免疫缺陷 ,容易遭受某种机遇性感染和引起一些不常见肿瘤 ,如卡波氏肉瘤 (Kaposis sarcoma,KS)及 B细胞淋巴瘤。笔者于 1996年 6月至 1999年 6月在非洲博茨瓦纳首都玛丽娜公主医院及佛朗西医院工作期间 ,发现艾滋病卡波氏肉瘤17例 ,报告如下。1　临床资料。本组 17例 ,男 7例 ,女 10例 ,年龄 18～ 38岁 ,平均年龄 2 8.5岁 ,均为黑色人种。发现 HIV阳性为…     

与人类免疫缺陷病毒相关性耳鼻咽喉部卡波济肉瘤21例报告

报告２１例与人类免疫缺陷病毒（ＨＩＶ）相关性耳鼻咽喉部卡波济肉瘤，其主要局部表现是鼻出血、鼻塞、咽喉干燥、异物感及结节状新生物，并对ＨＩＶ感染与卡波济肉瘤的关系、病例特点及诊断依据进行讨论。     

艾滋病患者伴发耳鼻咽喉疾病死亡4例报告

目的提高对艾滋病患者因耳鼻咽喉疾病导致死亡的认识。方法对4例艾滋病(AIDS)典型死亡病例进行回顾性分析。结果4例病例中,1例因免疫功能降低,扁桃体感染致口腔、咽腔、喉腔及颈部大面积脓肿形成致呼吸道堵塞死亡;1例因血小板计数降低,疑血功能障碍,出凝血时间延长,致持续流鼻血死亡;1例因化脓性中耳炎、乳突感染合并颅内并发症死亡;1例出现咽、喉、气管及支气管黏膜高度水肿致呼吸道堵塞,窒息死亡。结论艾滋病患者可因耳鼻咽喉疾病造成死亡,早期认识及诊断有利于治疗及预防。     

人类免疫缺陷病毒感染及艾滋病在耳鼻咽喉头颈外科的临床表现

目的 提高对人类免疫缺陷病毒感染者及艾滋病患者在耳鼻咽喉头颈外科临床表现的认识,以便能及时诊治并做好必要的防护.方法 分析55例坦桑尼亚首诊于耳鼻咽喉头颈外科的HIV感染者及艾滋病患者的临床表现及其预后.55例患者中男23例,女32例;年龄3～67岁,中位年龄31岁.结果 55例患者中腮腺肿胀17例次(30.9%);鼻腔、口腔、咽部卡波西肉瘤19例次(34.5%);慢性化脓性中耳炎12例次(21.8%);颈部肿块11例次(20.0%);咽部肿物7例次(12.7%);口腔及咽部黏膜糜烂溃疡6例次(10.9%);口腔白色念珠菌感染2例次(3.6%).HIV感染者或艾滋病患者经治疗后耳鼻咽喉科感染状况可缓解,但易反复发作,且逐渐加重.结论 HIV感染者及艾滋病患者可首诊于耳鼻咽喉头颈外科.对耳鼻咽喉科感染等治疗缓解后反复发作者,应除外是否合并HIV感染或是否为艾滋病患者.

Abstract：

Objective To improve the recognition of clinical manifestation of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) in otorhinolaryngology head and neck surgery, and to emphasize the early diagnosis, correct treatment and effective protection. Methods Fifty-five patients with HIV infection and AIDS encountered in the department of otorhinolaryngology head and neck surgery in Tanzania were included in this study. There were 23 males and 32 femals with age ranged from 3 -67 years, medium 31 year. The clinical manifestation and prognosis of the patients were analyzed and summed up. Results Parotid glands swelling was the most commonly seen clinical manifestation in the 55 cases. Among the cases reported here, 17 (30.9%) showed parotid glands swelling, 19(34. 5% ) had Kaposi's sarcoma in nasal cavity or oral cavity or pharynx,12(21.8% ) were accompanied with chronic suppurative otitis media, 11 (20.0%) had masses in the neck,7 ( 12.7% ) had masses in the pharynx, 6 ( 10.9% ) were seen to have ulcer in oral and pharyngeal mucosa,2(3.6% ) showed infection due to candidaalbicans. The infection in most cases could be controlled and symptoms relieved, but recurrence could occur over time and got worse gradually. Conclusions Many patients with HIV infection and AIDS first see a doctor in otorhinolaryngology head and neck surgery.Patients who had the above clinical manifestations in repeated poor results should be observed carefully,early diagnosis and treatment are important to prevent transmission, prolong life and maximize the quality of life of the patients.     

一般问题

950622艾滋病在耳典咽喉的表现及其预防/戴和平…/中级医刊一1994,29(11)一3~4 艾滋病是一种致死性疾病。近年来严重威胁着人类的生命及健康,而且40%的艾滋病患者可出现耳鼻咽喉症状和体征。艾滋病可分3期,即潜伏期,淋巴结病综合征(ALS)及显性艾滋病。根据耳鼻咽喉受侵犯的部位或范围的不同,可以出现如咽痛、吞咽困难、声嘶、呼吸困难、鼻塞脓涕、鼻蛆及耳溢等不同的症状。颈部淋巴结多为对称性肿大;约1/3的患者可发生Kap。51肉瘤(KS),作活检可诊断。口腔或咽部等处可发生茸毛状粘膜白斑病或念珠菌病,经真菌培养和镜检可确诊;还可发生卡…     

艾滋病扁桃体卡波肉瘤二例

在援助博茨瓦纳医疗队工作期间遇到 2例艾滋病 (即获得性免疫缺陷综合征 :ａｃｑｕｉｒｅｄｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｓｙｎｄｒｏｍｅ,ＡＩＤＳ) )扁桃体卡波肉瘤 (Ｋａｐｏｓｉｓａｒｃｏｍａ)患者 ,报告如下。例 1　 男 ,2 2岁 ,于 1999年 12月 3日因咽部异物感 2周就诊Ｎｙａｎｇａｂｗｅ医院耳鼻咽喉科。查右扁桃体ＩＩＩ度肿大 ,左扁桃体ＩＩ度肿大 ,暗紫色 ,无明显的渗出 ,鼻咽部可见散在溃疡。颈后多个散在淋巴结肿大 ,约 0 .5ｃｍ× 0 .8ｃｍ大小。上臂可见多个暗紫色的小隆起。抗 1型和 2型人类免疫缺陷病毒抗体(ａｎｔｉ…     

7例HIV感染者耳鼻咽喉表现(摘要)

近年来 ,性传播疾病患者有所增加 ,尤其在非洲地区艾滋病发病率较高 ,但发生于口腔及咽喉部者较少见 ,首诊于耳鼻咽喉科的患者更为少见。 2 0 0 0年 8月～ 2 0 0 1年 10月我在援喀麦隆医疗队工作的 14个月间遇到的耳鼻咽喉科就诊的 HIV感染者 7例 ,为提高耳鼻咽喉科医师对本病的认识 ,现报道如下。7例中男 2例 ,女 5例 ,除 1例为 3岁儿童外 ,其余均在 19～ 4 0岁之间 ,均为黑色人种。 3例出现耳部表现 ,其中耳廓带状疱疹 2例 ,化脓性中耳炎 1例。咽喉部表现者 4例 ,其中卡波济肉瘤 2例 ,1例分布于软硬腭、舌根和咽弓 ,另 1例分布于软腭及…     

艾滋病的耳鼻咽喉—头颈部临床表现

目的：识别艾滋病在耳鼻咽喉－头颈部的临床表现，探讨其治疗方法。方法：回顾性总结赞比亚６８例ＨＩＶ阳性患者的临床资料。结果：６８例发病年龄３个月－４６岁。其中急，慢性化脓性中耳炎１７例，萎缩性鼻为４例，鼻出血５例，慢性扁桃体炎１０例，口腔，咽喉部溃疡９例，颌下蜂窝织炎２例，腮区肿块９例，颈部及耳后肿块１２例。１８例合并肺结核，贫血，腹泻。     

鱼刺异物致颈部脓肿1例

患者,男,39岁.因右颈部锁骨上区域局部红肿反复发作2个月就诊于华西医院耳鼻咽喉头颈外科.2个月前,患者因误吞鱼刺引起疼痛,于当地医院急诊检查未见异物及明显黏膜损伤,口服抗生素后疼痛缓解.1周后再次出现右颈部不适,右颈根部红肿热痛,经静脉滴注青霉素、甲硝唑等药物致红肿消退.此后颈根部红肿反复发作4次,使用抗生素治疗效果显著.专科检查:口腔及咽喉未见异常.     

HIV阳性患者的口腔和口咽部肿瘤

调查人免疫缺陷病毒 (HIV)阳性患者口腔和咽部恶性肿瘤对放射治疗的敏感性。 8例患有口腔和口咽部恶性肿瘤的 HIV阳性患者 ,其中 4例为卡波齐肉瘤(KS) ,4例为鳞癌或恶性淋巴瘤。 7例行巨电压放疗 ,1例行平压放疗。放疗前后均测量体重 ,CD4 +细胞浓度 ,血红蛋白浓度。肿瘤体积缩小 4 0 %以上认为对放疗有效。口腔粘膜炎评分按以下标准 :0分为无异常变化 ;1分为轻度疼痛 ,不需止痛药 ;2分为中度疼痛 ,需用止痛药 ;3分为严重疼痛 ,需麻醉止痛药 ;4分为局部溃疡、出血或坏死。患者放疗过程中同时应用抗病毒药及抗霉菌药。平均随访时间为 2 .…     

Otolaryngologic and head and neck manifestations of acquired immunodeficiency syndrome (AIDS)

Patients with acquired immune deficiency syndrome (AIDS) frequently present with signs and symptoms referable to the head and neck. Three hundred ninety-nine patients with AIDS presented at the University of California, San Francisco and its affiliated hospitals from 1980 to April 1984. One hundred sixty-five patients (41%) with AIDS presented with, or had on initial evaluation, head and neck manifestations. Of that group, 58 (35%) had cutaneous, oral, and pharyngeal lesions of Kaposi's sarcoma; 51 (31%) had oral, pharyngeal, esophageal, or laryngeal candidiasis; 36 (22%) had chronic cough and shortness of breath; 13 (8%) had rapidly enlarging neck masses; and 7 (4%) had herpes simplex lesions. With the increasing number of cases of AIDS it is important for the otolaryngologist to be aware of these presentations.     

Kaposi's sarcoma of the trachea

The most common tracheal neoplasms are epidermoid carcinomas, papillomas and cylindromas. Kaposi's sarcoma, confined primarily to the trachea, is one of the rarest tumours. The clinical and histological picture of a case of Kaposi's sarcoma of the trachea in a young, pregnant woman, presenting with severe airway obstruction, is described here. The emergency tracheoscopy dislodged a mass from the trachea, which turned out to be a Kaposi's sarcoma on histology. Although Kaposi's sarcoma is one of the manifestations of AIDS, this patient had neither any underlying immunodeficiency nor any skin, visceral or lymphatic lesions.     

艾滋病在咽喉部表现6例

目的 通过对以咽痛和(或)发热为首诊症状的人类免疫缺陷病毒(HIV)感染者的分析,提高耳鼻喉科医生对该病的认识,避免误诊。方法 对首诊于耳鼻喉科的6 例HIV感染者的病史、临床表现及实验室检查等进行回顾性分析。结果 6例患者中3例为扁桃体炎,2例为口腔念珠菌感染,1例为咽喉部Kaposi肉瘤。结论 以咽痛为首诊的艾滋病患者,结合病史、临床表现及血清学检查可确诊,耳鼻喉科医生应予以重视。     

Otorhinolaryngological findings in AIDS patients: a study of 63 cases

Summary Patients with acquired immunodeficiency syndrome (AIDS) frequently show signs and symptoms involving the head and neck. We reviewed the clinical histories of 63 cases with AIDS, with patients treated from 1982 to December 1985, in our hospital. Findings referable to the head and neck were seen in 43 patients. Comparison with a previous study in San Francisco revealed remarkable differences. We found otolaryngological manifestations in 68% of the patients in contrast to 41% in this latter study. We saw more rapidly increasing neck masses, a greater incidence of shortness of breath and chronic cough, and an increased occurrence of candidiasis. The number of cases with Kaposi's sarcoma lesions was equal in both studies.     

Otorhinolaryngological findings in AIDS patients: a study of 63 cases

Patients with acquired immunodeficiency syndrome (AIDS) frequently show signs and symptoms involving the head and neck. We reviewed the clinical histories of 63 cases with AIDS, with patients treated from 1982 to December 1985, in our hospital. Findings referable to the head and neck were seen in 43 patients. Comparison with a previous study in San Francisco revealed remarkable differences. We found otolaryngological manifestations in 68% of the patients in contrast to 41% in this latter study. We saw more rapidly increasing neck masses, a greater incidence of shortness of breath and chronic cough, and an increased occurrence of candidiasis. The number of cases with Kaposi's sarcoma lesions was equal in both studies.     

妊娠期耳鼻喉疾病孕妇临床护理分析

目的分析妊娠期耳鼻喉疾病孕妇临床护理方法其效果。方法回顾性我院收治的78例妊娠期耳鼻喉疾病孕妇参与本研究,按照护理方法的差异将其分为对照组与观察组,每组39例,对两组护理前后的心理状态进行比较。结果护理1个月后,观察组与对照组HAMD评分、HAMA评分均有所降低,但观察组降低幅度明显大于对照组(P<0.05)。结论对妊娠期耳鼻喉疾病孕妇实施综合护理,可以帮助其改善心理状态,促进孕妇身心健康。     

Erythrophagocytosis in Kaposi's sarcoma in acquired immune deficiency syndrome

The ultrastructural morphology of Kaposi's sarcoma of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS) was examined electron-microscopically. Neoplastic spindle cells and vascular endothelial tumor cells are frequently involved in the phagocytosis of extravasated erythrocytes. Pericytes, fibroblasts, macrophages and other phagocytic cells of the tumor stroma also participate in this process. Erythrocytes are also phagocytized by some of the keratinocytes belonging to the intact surface epithelium covering the Kaposi's sarcoma lesion. Both the phenomenon of erythrophagocytosis and the presence of tubuloreticular structures in the cytoplasm of Kaposi's sarcoma cells in patients with AIDS seem to be prominent ultrastructural markers and thus of diagnostic value.     

ENT manifestation in COVID-19 patients

Objectiveto detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures.MethodsWe performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients.Resultswithin the included 1773 COVID-19 laboratory-confirmed positive patients, the most common ENT manifestations of COVID-19 were sore throat (11.3%) and headache (10.7%). While the other reported ENT manifestations were pharyngeal erythema (5.3%), nasal congestion (4.1%), runny nose or rhinorrhea (2.1%), upper respiratory tract infection (URTI) (1.9%), and tonsil enlargement (1.3%).ConclusionENT manifestations for COVID-19 are not common as fever and cough. But, a universal questionnaire using well-defined COVID-19 manifestations is needed to make the COVID-19 data precisely defined, complete and homogenous.