Oka S, Hanagiri T, Takenaka M, Baba T, Yasuda M, Ono K, Uramoto H, Takenoyama M, Yasumoto K
Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
Kyobu Geka. 2010 Nov;63(12):1022-5.
Descending necrotizing mediastinitis (DNM) originating from deep cervical infection is a rare and serious clinical condition with a high mortality rate. Clinical feature of 5 patients undergone surgical drainage for DNM, between 2006 and 2009 were assessed. There were 3 male and 2 female patients whose age ranged from 57 to 83 years old (mean 69.8). All 5 patients had no underlying disease except for 1 patient with severe dental caries. The primary infections of these patients were tonsillitis and pharyngitis. The mean duration from onset of symptom to the referral to our hospital was 14 days (ranged 2 to approximately 41). Two patients underwent cervical drainage for upper mediastinum, and 3 patients were required mediastinal drainage by thoracotomy. There was no post-operative death. Early and aggressive surgical drainage of the neck and mediastinum by a multidisciplinary team of surgeons is very important in the treatment of DNM.
源自颈部深部感染的下行性坏死性纵隔炎（DNM）是一种罕见且严重的临床病症，死亡率很高。对2006年至2009年间因DNM接受手术引流的5例患者的临床特征进行了评估。有3例男性和2例女性患者，年龄在57至83岁之间（平均69.8岁）。除1例患有严重龋齿的患者外，所有5例患者均无基础疾病。这些患者的原发性感染为扁桃体炎和咽炎。从症状出现到转诊至我院的平均持续时间为14天（范围为2至约41天）。2例患者接受了上纵隔的颈部引流，3例患者需要通过开胸进行纵隔引流。无术后死亡病例。由多学科外科医生团队对颈部和纵隔进行早期积极的手术引流在DNM的治疗中非常重要。
