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颈静脉扩张:印度的临床病例

Jugular phlebectasia: clinical scenario in India.

作者信息

Yaadhavakrishnan Rajprakash Dharmapuri, Navaneethan Nagendran

机构信息

Department of ENT, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, 603319 Tamilnadu India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(1):13-7. doi: 10.1007/s12070-014-0729-z. Epub 2014 Jun 6.

Abstract

Jugular phlebectasia is fusiform dilatation of internal jugular vein seen in childrens. It usually occurs in children but can occur at any age. It usually presents as unilateral swelling in the neck found during coughing and shouting. It is usually asymptomatic, so it is often ignored or misdiagnosed. Differential diagnosis include laryngocele, cavernous hemangioma, cystic hygroma, branchial cyst. Treatment is usually conservative as complications like thrombosis and horners syndrome are very rare. Non invasive investigations like Doppler sonogram and are usually done to diagnose this condition. We report two cases of jugular phlebectasia, who presented to our out patient department with history of swelling in the right side of neck which increases on crying and shouting. Doppler sonogram and ultrasound was done to diagnose the condition. There seems be lack of knowledge among medical fraternity in various specialities. So a questionnaire was prepared to assess the knowledge among resident doctors, general practitioners, Otorhinolaryngologists, paediatricians. Questionnaire was posted in social networking sites and the feedback was obtained. Out of the 150 interns in our hospital, only one (0.66 %) was able to explain about the condition. In general practitioners group containing 369 respondents, only 4 (1.08 %) knew the condition and have seen patients. A pediatricians group containing 312 respondents only 23 (7.37 %) pediatricians knew the condition, 289 (92.62 %) persons had no idea about the treatment. Otorhinolaryngologists group containing 328 respondents. 21 (6.40 %) knew the condition, 293 (89.3 %) have no idea. The Chi square test shows that the specialty of the respondent like pediatrician and ENT practitioner have more knowledge than the other for jugular phlebectasia at p < 0.0001.

摘要

颈静脉扩张是儿童期出现的颈内静脉梭形扩张。它通常发生于儿童,但也可发生于任何年龄。通常表现为咳嗽和喊叫时发现的颈部单侧肿胀。通常无症状,因此常被忽视或误诊。鉴别诊断包括喉膨出、海绵状血管瘤、囊性水瘤、鳃裂囊肿。由于血栓形成和霍纳综合征等并发症非常罕见,治疗通常采取保守治疗。通常采用多普勒超声等非侵入性检查来诊断这种疾病。我们报告两例颈静脉扩张病例,他们因右侧颈部肿胀病史前来我院门诊,哭闹和喊叫时肿胀加剧。通过多普勒超声和超声检查来诊断病情。各医学专业领域的医务工作者似乎对此缺乏了解。因此,我们准备了一份问卷来评估住院医生、全科医生、耳鼻喉科医生、儿科医生的相关知识。问卷发布在社交网站上并获得了反馈。在我院150名实习生中,只有1人(0.66%)能够解释这种病症。在369名全科医生组成的小组中,只有4人(1.08%)了解这种病症并见过相关患者。在312名儿科医生组成的小组中,只有23名(7.37%)儿科医生了解这种病症,289人(92.62%)对其治疗方法一无所知。在328名耳鼻喉科医生组成的小组中,21人(6.40%)了解这种病症,293人(89.3%)对此一无所知。卡方检验表明,在p<0.0001时,像儿科医生和耳鼻喉科医生这样的受访者专业领域对颈静脉扩张的了解比其他领域更多。

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