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[牙源性化脓性败血症性转移灶]

[Septic metastases of suppuration of odontogenic origin].

作者信息

Juncar M, Popa A R, Lung T, Onişor F

机构信息

Clinica de Chirurgie Orală şi Maxilo-Facială I, Cluj Napoca, România.

出版信息

Chirurgia (Bucur). 2011 May-Jun;106(3):359-64.

Abstract

The infections of odontogenic origin, set in the soft tissues region of the viscerocranium are among the most frequent conditions specific to this anatomical level. A distinct category among these, represented by the conditions with diffuse character, may have serious forms, developing systemic septic metastases. The current paper displays a study approaching seven cases of odontogenic diffuse infections with metastases at distance. The ways in which the septic metastases appeared, as well as the topic and general prescribed treatment have been analyzed. The expanding at distance of the suppuration occurred at those patients who were suffering from cervical necroziting fasciitis associated to some immunodepressing conditions. Out of the 7 patients involved in the study, 4 were suffering from uncompensated diabetes and obesity. All those 7 patients had septic conditions localized in mediastinal region, and in 3 cases hepatic septic affections were observed. The best treatment possible for these conditions proved to be the surgical one associated with that concerned with the sustenance of the general state of health, the rebalancing of the homeostatic constants and the antibacterial one. The post-surgical evolution in case of 5 patients was a good one, in case of 2 patients being unfavourable because of the appearance of the multiorganic insufficiency and of death.

摘要

起源于牙源性的感染发生在内脏颅骨的软组织区域,是该解剖层面最常见的病症之一。其中以弥漫性病症为代表的一个独特类别,可能会发展为严重形式,出现全身脓毒性转移。本文展示了一项针对7例伴有远处转移的牙源性弥漫性感染病例的研究。分析了脓毒性转移出现的方式以及局部和全身的规定治疗方法。化脓的远处扩散发生在患有与某些免疫抑制状况相关的颈部坏死性筋膜炎的患者身上。在参与研究的7名患者中,4名患有未代偿性糖尿病和肥胖症。所有这7名患者的脓毒症均局限于纵隔区域,3例观察到肝脏脓毒症。事实证明,针对这些病症的最佳治疗方法是手术治疗,同时配合维持总体健康状态、重新平衡体内稳态常数以及抗菌治疗。5例患者术后恢复良好,2例患者因出现多器官功能不全和死亡而预后不佳。

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