咽喉部鱼刺异物迁移致颈部脓肿分析  

Neck abscess caused by foreign body of fish bone in pharynx

作　　者：王耀文[1] 张媛媛[2] 顾亚军 李吉[1] 欧阳天斌[1] 章伟敏[1] 孔德秋[1] 唐世雄[1] 

机构地区：[1]宁波市第一医院耳鼻咽喉科,浙江宁波315000 [2]济宁市第一人民医院耳鼻咽喉科,山东济宁272000 [3]南京鼓楼医院耳鼻咽喉科,江苏南京210000

出　　处：《中国耳鼻咽喉头颈外科》2016年第12期716-718,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨咽喉部鱼刺异物迁移致颈部脓肿的临床特征、辅助检查、治疗手段及预防策略。方法回顾性分析8例咽喉部鱼刺异物迁移致颈部脓肿的临床资料。结果 7例有异物误咽史。2例鱼刺迁移至胸锁乳突肌内,3例至舌骨舌肌内,1例至甲状软骨上角与颈动脉鞘之间,1例至咽后间隙,1例至甲状腺内侧。6例行彩色B超检查,5例发现异物。所有患者均行颈部CT检查,4例发现异物。全部患者均通过颈外侧入路颈部探查取出异物。结论对伴有异物吞咽史的颈部脓肿患者首先考虑异物迁移。彩色B超检查有明确价值,薄层CT及三维重建可作为补充检查手段,手术为首选。医疗安全教育、提高医患警惕为主要预防手段。OBJECTIVE To discuss the clinical characteristics,examinations,treatment and prevention strategy of the neck abscess caused by foreign body of fish bone in pharynx.METHODS We retrospectively reviewed the data of 8 cases with neck abscess which was caused by foreign body of fish bone in pharynx from Jan.2012 to Feb.2016.RESULTS 7 patients had accidental swallowing history of fish bone.The fish bones migrated to sternocleidomastoid muscle in 2 cases,hyoglossus muscle in 3 cases,retropharyngeal space in one case,the space between thyroid cartilage and carotid sheath in one case,and the inner side of thyroid gland in 1 case.6 patients undertook ultrasound type B examination,and foreign bodies were found in 5 cases.All the patients undertook computer tomography scan（CT）,foreign bodies were found in 4 cases.The foreign bodies were removed through lateral cervical approach.CONCLUSION As for the neck abscess with foreign body accidental swallowing history,we should consider foreign body migration at first.B-ultrasound scan is the first choice to detect the foreign body.The neck exploration and removal of the foreign body is the main treatment strategy.To prevent the fish bone migration,we need to pay more attention to the medical education and increase the awareness of the risk factors.

关 键 词：颈 咽 脓肿 异物 

分 类 号：R762[医药卫生—耳鼻咽喉科]