口底重症多间隙感染41例患者诊治的回顾性分析  

Treatment of severe cellulitis of the mouth floor:A retrospective study of 41 cases

作　　者：乔波[1] 张浚睿[1] 陆斌[1] 孔亮[1] 刘芳[2] 封兴华[1] 

机构地区：[1]第四军医大学口腔医学院口腔颌面外科,西安710032 [2]空军总医院感染管理科

出　　处：《实用口腔医学杂志》2015年第5期682-685,共4页Journal of Practical Stomatology

摘　　要：目的：回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法：对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用（种类及疗程）、手术干预及转归等方面进行总结及系统性分析。结果：男女比例为2．4∶1，年龄10～93岁（平均46．23岁），农村城市比例为3∶1。14．6％患者初步诊断不准确。31％患者在发病后5 d 内就诊。82．9％患者为牙源性感染，35％患者初诊时炎症已扩散至咽旁间隙、翼下颌间隙或者合并颈部感染，7．5％患者感染扩散至纵膈；2例患者入院后已合并严重纵膈及肺部感染，转呼吸内科治疗，1例因肾衰转泌尿外科治疗；38例患者入院后及时给予静脉滴注抗生素抗感染治疗、尽早完成切开引流，痊愈出院，平均住院21 d。结论：牙源性感染的重症口底多间隙感染最多见，其治疗的关键在于早期诊断，维持呼吸道通畅，选择合适的抗生素，尽早切开引流、综合治疗去除病因。Objective：To analyze clinical data of 41 patients with severe mouth floor cellulitis.Methods：Patient＆#39;s gender,age, epidemiological characteristics,origin of inflammation,symptoms of the disease,primary diagnosis,concomitant diseases,complica-tions,clinical diagnosis,the use of antibiotics （type and course）,operation and outcomes were reviewed.Results：The male-fe-male ratio of the patients was 2.4∶1 .Age distribution was 1 0 -93 years old（with the mean of 46.23）.The cases from urban-rural area was 3∶1 ,1 4.6% of the patients＆#39;primary diagnosis was not accurate.Only 31 % of the patients went to doctors in the first 5 days from the beginning of the disease.82.9% of the mouth floor cellulites were odontogenic.35% of the cases were diagnosed to be in-fectious diffusion to parapharyngeal,pterygomandibular spaces or to be complicating with neck infection at first examination.Infec-tion of 7.5% of the cases were spread to mediastinum.All the patients were administered with antibiotics and completed the surgical drainage as early as possible,except 2 transfered to respiratory medicine for mediastinum serious mediastinal and pulmonary infection and 1 to urinary surgery for renal failure.Conclusion：Odontogenic infection is most common for mouth floor cellulitis.Accurate di-agnose,maintenance of airway and initiate suitable antibiotics are rery important for the treatment of severe cellulitis of mouth floor. Prompt surgical drainage and comprehensive treatments are also essential to prevent patients from severe complications.

关 键 词：口底 蜂窝织炎 牙源性感染 呼吸道 脓肿 

分 类 号：R782.3[医药卫生—口腔医学]