Crosbie Robin A, Nairn Jonathan, Kubba Haytham
Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland.
University of Dundee Medical School, Dundee, Scotland.
Int J Pediatr Otorhinolaryngol. 2016 Aug;87:134-8. doi: 10.1016/j.ijporl.2016.06.025. Epub 2016 Jun 7.
Paediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol.
Retrospective audit of paediatric patients admitted with periorbital cellulitis, 2012-2015.
Total of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%.
Our audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms.
小儿眶周蜂窝织炎是一种常见病症。准确评估可能具有挑战性，正确使用CT成像至关重要。我们参照CT扫描及对我们方案的遵循情况，对四年间收入我院的病例进行了审核。
对2012年至2015年因眶周蜂窝织炎入院的儿科患者进行回顾性审核。
共纳入243例患者，平均年龄4.7岁，男性略占优势，中位住院时间为2天。243例中有48例（20%）在住院期间接受了CT检查，其中25例（52%）接受了手术引流。按照方案，所有眼眶扫描均同时进行脑部CT检查；初次扫描时均未发现颅内阳性结果。有三名儿童随后出现颅内并发症；均接受了抗生素治疗。我们的30天内再入院率为2.5%。
我们的审核证明了规范诊疗行为的益处，CT检查率低，手术率高且无脓肿漏诊，这支持了该方案。对于那些没有神经体征或症状的儿童，在所有初始成像序列中常规避免进行脑部CT检查可能有一定道理。
