Yang Shih-Wei, Lee Ming-Hsun, Lee Yun-Shien, Huang Shu-Huan, Chen Tai-An, Fang Tuan-Jen
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
ORL J Otorhinolaryngol Relat Spec. 2008;70(4):249-56. doi: 10.1159/000132094. Epub 2008 May 16.
To review our experience in the treatment of deep neck abscesses, including analysis of the contributing factors related to the life-threatening complications and the effects of empiric antibiotics on the outcomes.
A retrospective study and statistical analysis of patients with deep neck abscesses treated at Chang Gung Memorial Hospital between April 2000 and April 2006.
A total of 105 patients were enrolled in this study, including 66 males and 39 females with age ranging from 18 to 93 years. The result of logistic regression showed that old age, patients with underlying systemic diseases (p<0.05) and ineffective empiric antibiotics (p<0.01) had statistically significant correlation with life-threatening complications. When the age was older than 65 years, the empiric antibiotics were not effective, the way of drainage of the abscess was transcervical incision, the initial deep neck abscess involved more than 1 space, or the patient had underlying systemic diseases or complications, the duration of hospital stay tended to be longer (p <0.01).
Even when adequately draining the abscess, the treatment of deep neck abscess in old-age patients more than 65 years, or the patients with ineffective empiric antibiotics or underlying systemic diseases should be more aggressive because life-threatening complications happen more frequently.
回顾我们治疗深部颈部脓肿的经验，包括分析与危及生命并发症相关的促成因素以及经验性抗生素对治疗结果的影响。
对2000年4月至2006年4月在长庚纪念医院接受治疗的深部颈部脓肿患者进行回顾性研究和统计分析。
本研究共纳入105例患者，其中男性66例，女性39例，年龄范围为18至93岁。逻辑回归结果显示，高龄、有潜在全身性疾病的患者（p<0.05）以及经验性抗生素治疗无效的患者（p<0.01）与危及生命的并发症有统计学显著相关性。当年龄大于65岁、经验性抗生素治疗无效、脓肿引流方式为经颈切开、初始深部颈部脓肿累及超过1个间隙，或患者有潜在全身性疾病或并发症时，住院时间往往更长（p<0.01）。
即使脓肿得到充分引流，对于65岁以上的老年患者、经验性抗生素治疗无效的患者或有潜在全身性疾病的患者，深部颈部脓肿的治疗也应更积极，因为危及生命的并发症更频繁发生。
