82例颈深部感染诊治分析  

Deep neck infection: clinical analysis of 82 cases

作　　者：徐建慧[1] 叶飞[1] 傅敏仪[1] 陈国平[1] XU Jianhui;YE Fei;FU Minyi;CHEN Guoping(Department of Otolaryngology Head and Neck Surgery,Zhongshan People’s Hospital,Zhongshan,Guangdong,528400,China)

机构地区：[1]中山市人民医院耳鼻咽喉头颈外科

出　　处：《中国耳鼻咽喉头颈外科》2019年第11期589-591,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨颈深部感染的临床特点和治疗经验。方法回顾性分析我科2013年1月~2018年12月收治的82例颈部感染患者的临床资料,包括临床表现、感染部位、病因、细菌学、住院时长、并发症、治疗方式及预后等。结果吞咽痛、吞咽困难是最常见的临床表现,共53例(64.6%),43例(52.4%)患者无明确病因,46例(56.1%)为多间隙感染,17例(20.7%)伴有糖尿病,16例(19.5%)发生严重并发症。伴有糖尿病患者和发生严重并发症患者住院时间更长(P=0.03,P=0.01),糖尿病是颈深部感染发展至纵膈的危险因素(P=0.015)。8例(9.7%)患者行气管切开,2例(2.4%)死亡。结论对颈深部感染合理应用抗生素,脓肿范围大者应尽早切开引流,高度重视糖尿病患者,预防和积极处理严重并发症,提高治愈率。OBJECTIVE To discuss the clinical features and treatment experience of deep neck infection. METHODS This retrospective study with 82 cases of deep neck infection was performed from January 2013 to December 2018. Parameters included presentation, etiology, site, bacteriology, comorbidity, length of hospitalization, complications, treatment and prognosis. RESULTS In our study, odynophagia and dysphagia were the most common symptoms, identified in 53 cases(64.6%). In 43 cases etiological factors were unknown(52.5%). Multispace infection developed in 46 cases(56.1%). Diabetes was found as a co-morbid condition in 17 cases(20.7%), Sixteen cases had life-threatening complications(19.5%). Patients with diabetes and life-threatening complications required longer hospitalizations(P=0.03, P=0.01).Diabetes mellitus was a risk factor for the extension of deep neck infection into the mediastinal space(P=0.015). Eight cases required emergency tracheotomy(9.7%), Two cases died(2.4%). CONCLUSION All patients must be initially treated with appropriate antibiotics. Surgical drainage is needed as soon as possible when big abscess is diagnosed. More attention should be paid to diabetic patients and it is essential to prevent and treat life-threatening complications.

关 键 词：颈 感染 引流术 气管切开术 

分 类 号：R47[医药卫生—护理学]