口底多间隙感染文献回顾及临床分型探讨  

Literature Review and Clinical Classification of Cellulitis of Mouth Floor

作　　者：王杰[1] 李树华[1] 姚婷[1] 刘国旗[1] 蒋振华[1] 邓伟[1] 夏少华[1] 

机构地区：[1]绵阳市中心医院耳鼻咽喉科,四川绵阳621000

出　　处：《四川医学》2017年第5期568-570,共3页Sichuan Medical Journal

摘　　要：目的对我院口底多间隙感染进行资料分析。方法纳入我院2014年1月至2016年8月就诊于我科的口底多间隙感染伴(不伴)颈-纵膈感染患者21例诊疗资料进行分析。结果 21例口底多间隙感染患者均为男性,年龄35~56岁,平均年龄(37.1±11.8)岁;糖尿病患者11例。牙源性13例,颌下腺感染4例,腮腺感染2例,外伤性感染1例;口底多间隙感染8例,口底多间隙合并颈部感染10例,口底多间隙合并颈-纵膈感染3例。患者在入院后积极完善相关检查、采用综合治疗,所有患者均使用广谱抗菌药联合(不联合)替硝唑抗感染治疗,口底间隙感染行颏下切开引流4例、颌下切开引流2例、1例未切开引流;合并颈部感染者均行颈部切开引流及间隙扩张术;合并纵膈感染者均行颈-纵膈切开引流术。经2~3周治疗,平均住院日(14.5±5.3)d,所有患者均治愈出院。结论根据临床表现、辅助检查,确定疾病的程度、分型和感染间隙部位,把握手术时机,及时介入可提高生存率。细菌培养与药敏确定抗生素选择,手术时机和手术入路选择尤为重要。Objective To analyze the data of cellulitis of mouth floor of our hospital. Methods The clinical data of 21 patients with cellulitis of mouth floor in our hospital from January 2014 to August 2016 were retrospectively analyzed. Results 21 patients with cellulitis of mouth floor were male, aged from 35 to 56 years, mean age of（37. 1 ± 11.8 ） years old, among them 11 pa- tients with diabetes. There are 13 cases of Odontogenic infection,4 cases of Submandibular gland infection,2 cases of parotid gland infection, 1 case of traumatic infection among them. And there were 8 cases with cellulitis of mouth floor, 10 cases with cellulitis of mouth floor combined with neck infection and 3 cases with cellulitis of mouth floor combined with septa longitudinale infection. Pa- tients were actively improved and cured with comprehensive treatment after admission. All patients were using broad spectrum anti- biotic eomhined（ or not eombined） with tinidazole anti-infective treatment. Four of the cases with eellulitis of mouth floor were under the chin incision and drainage,two of them were under submandibular incision and drainage and one case was not under incision and drainage. All of the cases with eellulitis of mouth floor combined with neck infection were under neck incision and drainage and gap dilation. And all of the cases with cellulitis of mouth floor combined with septa longitudinale infection were under septa longitu- dinal incision and drainage. After 2 to 3 weeks of treatment, the average length of hospital stay were （ 14. 5 ± 5.3） days,and all pa- tients were cured. Conclusion We can improve the survival rate by determining the degree of disease, type and infection location based on clinical manifestations and auxiliary examination,grasping the timing of surgery and intervention timely. Bacterial cuhure and drug sensitivity to determine the choice of antibiotics, surgical timing and smgical approach are particularly important.

关 键 词：口底多间隙感染 临床分型 

分 类 号：R782.3[医药卫生—口腔医学]