Bondy Peter, Grant Thomas
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia 23708, USA.
Ann Otol Rhinol Laryngol. 2008 Sep;117(9):679-83. doi: 10.1177/000348940811700909.
We wanted to describe what Lemierre's syndrome is and what risk factors may be involved, and to understand the roles, if any, of antibiotics and anticoagulants in the treatment of this syndrome.
We performed a review of the pertinent literature regarding Lemierre's syndrome, as well as a review of otology, obstetrics and gynecology, and internal medicine literature looking at both anticoagulation and long-term antibiotic treatment for septic thrombosis.
The vast majority of patients with Lemierre's syndrome are successfully treated nonsurgically with antibiotics and, often, anticoagulation as well. Surgical intervention is reserved for those cases with persistent showering of septic emboli or continued propagation of the thrombosis. Although anticoagulation is commonly used in other specialties for similar septic thromboses, its role in Lemierre's syndrome is unclear at the present.
Because Lemierre's syndrome is so rare, it is difficult to ascertain absolutely the need for either anticoagulation or long-term antibiotic therapy. At this time, the risks and benefits of providing either therapy must be weighed against the potential complications of incompletely treating septic thrombosis.
我们想要描述勒米尔综合征是什么以及可能涉及哪些危险因素，并了解抗生素和抗凝剂在该综合征治疗中的作用（若有）。
我们对有关勒米尔综合征的相关文献进行了综述，同时也对耳科学、妇产科以及内科文献进行了综述，这些文献涉及抗凝和针对脓毒性血栓形成的长期抗生素治疗。
绝大多数勒米尔综合征患者通过抗生素治疗（通常还联合抗凝治疗）可成功接受非手术治疗。手术干预适用于那些脓毒性栓子持续播散或血栓持续扩展的病例。尽管抗凝在其他专科常用于类似的脓毒性血栓形成，但目前其在勒米尔综合征中的作用尚不清楚。
由于勒米尔综合征非常罕见，很难绝对确定抗凝或长期抗生素治疗的必要性。此时，必须权衡提供这两种治疗的风险和益处与不完全治疗脓毒性血栓形成的潜在并发症。
