成人急性会厌炎临床分析  

Clinical analysis of acute epiglottitis in adults

作　　者：季青[1] 刘英[1] 王媛[2] 王琪[3] 

机构地区：[1]清华大学医院耳鼻咽喉科,北京100084 [2]北京航天总医院耳鼻咽喉科,北京100076 [3]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730

出　　处：《中国耳鼻咽喉头颈外科》2009年第8期455-456,共2页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨成人急性会厌炎的临床特点、治疗和预后。方法本研究共纳入75例成人急性会厌炎患者,治疗采用足量抗生素和糖皮质激素,其中6例行气管切开术。结果本组75例急性会厌炎患者最常见症状为咽痛(100%)、吞咽痛(100%)、吞咽困难(96%),65.33%的患者感呼吸困难;全部患者治疗后均获得痊愈,8%的患者予以气道干预;有糖尿病组气管切开率高于无糖尿病组(P<0.05)。结论①当患者感明显的吞咽痛而口咽部未见明显异常时,勿忘检查喉部,以免遗漏急性会厌炎;②病情发展快,IV度呼吸困难预示需进行气道干预;③伴糖尿病的成人急性会厌炎较无糖尿病者易发生急性上呼吸道梗阻;④绝大多数成人急性会厌炎患者可通过保守治疗得以痊愈。OBJECTIVE To study the clinical features, management and outcome of adult patients with acute epiglottitis. METHODS A retrospective clinical study was conducted on 75 adult patients with acute epiglottitis. All the patients were given intravenous antibiotics and dexamethasone in an adequate dosage. Six patients underwent tracheotomy. RESULTS The most common symptoms were sore throat （100%） , odynophagia （100%） and dysphagia （96.00%） . Dyspnea was found in 65.33% of patients. All patients recovered and only 8% of patients needed airway intervention. The incidence of tracheotomy was higher in patients with diabetes mellitus than those without diabetes mellitus （P〈0.05） . CONCLUSION 1. When the patient feels obvious odynophagia, but there is no visible inflammation in oropharynx, it is necessary for us to check the larynx in order to avoid missing diagnosis of acute epiglottitis. 2.If the patients present with rapid progress, fourth grade dyspnea, then a prompt airway intervention might be needed. 3.Adult patients with diabetes mellitus are more prone to make upper airway obstruction than those without diabetes mellitus. 4.Most adults who have acute epiglottitis can be treated conservatively and fully recovered.

关 键 词：会厌炎 成年人 嗜血菌 流感 气道阻塞 

分 类 号：R767.5[医药卫生—耳鼻咽喉科] R653[医药卫生—临床医学]