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[成人会厌炎]

[Epiglottitis in adults].

作者信息

Harell M, Eviatar E, Flaksman H, Segal S

机构信息

Dept. of Otolaryngology, Edith Wolfson Medical Center, Holon.

出版信息

Harefuah. 1990 Sep;119(5-6):128-31.

PMID:2227684
Abstract

Acute epiglottitis in the child is an emergency, well known to pediatricians, that requires rapid diagnosis and treatment. Aggressive treatment in recent years has markedly decreased mortality (17). Acute epiglottitis in adults has been thought to be rare, but lately numerous studies have shown an increase in the disease. We present 19 older patients, aged 13-72 (mean 44.7 years), with acute epiglottitis. A most important finding was the relatively long time from onset of symptoms until diagnosis, averaging 2.5 days. All the blood and throat cultures were negative, except for a single throat culture which yielded Pseudomonas aeruginosa. The most common presenting symptoms were severe sore-throat and dysphagia; half presented with some respiratory distress. Diagnosis was usually made on indirect laryngoscopy, but lateral X-ray of the soft tissues of the neck was found to be highly reliable. Treatment was usually conservative, including antibiotics, rehydration and steroids to alleviate edema. All patients were under strict observation for the first 48 hours, but only 1 required intubation. There were no deaths.

摘要

儿童急性会厌炎是一种儿科医生熟知的急症,需要迅速诊断和治疗。近年来积极的治疗显著降低了死亡率(17)。成人急性会厌炎一直被认为较为罕见,但最近大量研究表明该疾病有所增加。我们报告了19例年龄在13至72岁(平均44.7岁)的成人急性会厌炎患者。一个最重要的发现是从症状出现到诊断的时间相对较长,平均为2.5天。除一份咽喉培养物培养出铜绿假单胞菌外,所有血液和咽喉培养结果均为阴性。最常见的症状是严重咽痛和吞咽困难;半数患者有一些呼吸窘迫症状。诊断通常通过间接喉镜检查做出,但发现颈部软组织侧位X线检查高度可靠。治疗通常是保守的,包括使用抗生素、补液和类固醇以减轻水肿。所有患者在最初48小时内都受到严格观察,但只有1例需要插管。无死亡病例。

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