颈部间隙感染23例诊治体会  

Experience in diagnosis and treatment of 23 cases of neck space infection

作　　者：徐进敬[1] 胡京华 吴元庆[1] 邓毅[1] 戚建伟[1] XU Jinjing;HU Jinghua;WU Yuanqing;DENG Yi;QI Jianwei(Department of Otolaryngology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)耳鼻咽喉科,南京210006

出　　处：《中国眼耳鼻喉科杂志》2021年第2期120-124,128,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金青年科学基金项目(81601477);南京医科大学科技发展基金一般项目(NMUB2019166)。

摘　　要：目的总结诊断及治疗颈部间隙感染尤其是颈深部多间隙感染的经验与体会。方法收集我科2012年12月~2019年12月期间收治的23例颈部间隙感染患者资料,对发病原因、临床特点、诊断及治疗过程进行分析,总结经验。结果23例患者均予抗菌药物治疗。14例检查提示脓肿形成的患者中,有4例行穿刺抽脓,5例行切开引流,5例联合B超引导下穿刺抽脓及切开引流。所有患者均治愈出院,伤口Ⅰ期愈合,其中有2例合并纵隔及胸部脓肿,经多学科协作治疗后痊愈。结论颈部间隙感染应早期积极使用抗菌药物治疗,保持呼吸道通畅。当考虑颈部脓肿形成时,应尽早行脓肿穿刺引流或手术切开排脓。多学科协作可降低气管切开率,从而减轻手术创伤;负压封闭式引流技术等有助于缩短病程。Objective To analyze and summarize the experience in diagnosis and treatment of neck space infection,especially deep neck multi space infection.Methods Data of 23 patients with neck space infection in our department from December 2012 to December 2019 were collected.Summarizing The experience was summarized by analyzing the pathogenesis,clinical characteristics,diagnosis and treatment process.Results All 23 cases with neck infection were treated with anti-microbial therapy.There were 14 patients with abscess formation indicated by related examinations,4 of which were treated with puncture to extract pus,5 cases underwent surgical treatment,5 cases underwent combination of puncture pumping pus guided by ultrasound and surgical treatment.All patients were cured by 1st intention and discharged,including 2 cases with mediastinal abscess and breast abscess,healed after treatment with multidisciplinary collaboration.Conclusions In the diagnosis and treatment of neck space infection,antibacterial drugs should be actively used early and the respiratory tract should be kept unobstructed.When abscess is form ed,puncture or incision drainage should be done as soon as possible.Multidisciplinary collaboration may decrease the rate of tracheotomy,and lessen the surgical trauma;Vacuum sealing drainage can also be used to shorten the course of disease.

关 键 词：颈部感染 间隙 脓肿 穿刺 

分 类 号：R653[医药卫生—外科学]