下行性坏死性纵隔炎的临床诊治分析  

Diagnosis and therapy of patients with descending necrotizing mediastinitis

作　　者：卢万里[1] 金哲[1] 

机构地区：[1]南阳市中心医院胸外科,河南南阳473009

出　　处：《医药论坛杂志》2015年第2期64-65,68,共3页Journal of Medical Forum

摘　　要：目的探讨下行性坏死性纵隔炎的临床诊断和治疗,为临床提高该病的早期诊断率和治愈率提供依据。方法回顾性分析收治的9例下行性纵隔炎的临床资料。依据患者临床表现,颈、胸部CT扫描特征确诊。治疗方法包括积极抗感染和手术切开引流等。结果痊愈7例,死亡2例,均死于感染性休克、呼吸衰竭。结论患者病史、症状和体征,颈、胸部CT检查是确诊DNM的有效方法。根据CT分型采取个体化的切开引流,早期、足量应用广谱抗生素和支持治疗是降低病死率的有效手段。Objective To explore the diagnosis and treatment of descending necrotizing mediastinitis. Methods We retrospectively analyzed the records of nine descending necrotizing mediastinitis（ DNM） patients treated at our Hospital from January 2003 to November 2013. The diagnostic criteria included clinical manifestations,neck and chest CT scans.Antibiotic treatment,incision drainage,and other symptomatic treatments were applied. Results After treatment,seven patients recovered and two died of Septic shock and Respiratory failure. Conclusion The valid diagnosed criteria of DNM include history,sign,symptom and CT scanning of neck and chest. DNM mortality can be reduced by individual surgical managements,employing broad spectrum antibiotics early in treatment and Strengthenning systemic treatment.

关 键 词：下行性坏死性纵隔炎 感染 外科引流 

分 类 号：R655.5[医药卫生—外科学]