Hah Young-Min, Jung Ah Ra, Lee Young Chan, Eun Young-Gyu
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
J Pediatr Surg. 2018 Apr;53(4):666-670. doi: 10.1016/j.jpedsurg.2017.06.013. Epub 2017 Jun 27.
The aim of this study was to identify risk factors for transcervical approaches in the treatment of pediatric deep neck infections (DNIs).
We performed a retrospective analysis of data from patients who were diagnosed with DNIs. All medical records were reviewed for demographic characteristics, presenting signs and symptoms, duration of symptoms, size of abscess, laboratory results, duration of intravenous (IV) antibiotic administration, duration of hospitalization, medical treatment, and type of surgical drainage (oral or transcervical approach). We divided 126 patients into three groups according to the approach used to treat the DNI: non-surgical, intraoral surgical and external transcervical surgical.
The average ages of the non-surgical, intraoral, and transcervical groups were 10.46±5.27, 12.75±4.82 and 5.54±5.15years, respectively. The transcervical approach was used to treat younger patients (p<0.001). Abscess size was significantly larger for the transcervical group compared to the other groups (5.72±8.93, 13.51±14.74, 18.36±16.05mm, non-surgical, intraoral, and transcervical group, respectively, p=0.009). The average duration of IV antibiotic administration for the transcervical group was 9.77±3.27days, which was significantly higher than those for the other groups (5.49±3.28 for non-surgical and 6.13±2.85 for intraoral, p<0.001). Multivariate analysis revealed that submandibular abscesses (Exp (B)=5.254, p=0.012) were the only significant risk factor for the transcervical approach in surgical treatment of DNIs.
Submandibular space abscesses were the only significant risk factor for the transcervical approach in the treatment of pediatric DNI patients.
III.
本研究旨在确定小儿深部颈部感染（DNI）治疗中经颈入路的危险因素。
我们对诊断为DNI的患者数据进行了回顾性分析。查阅了所有病历，了解人口统计学特征、临床表现和症状、症状持续时间、脓肿大小、实验室检查结果、静脉注射抗生素的持续时间、住院时间、治疗方法以及手术引流类型（经口或经颈入路）。我们根据治疗DNI的方法将126例患者分为三组：非手术组、经口手术组和经颈外手术组。
非手术组、经口组和经颈组的平均年龄分别为10.46±5.27岁、12.75±4.82岁和5.54±5.15岁。经颈入路用于治疗年龄较小的患者（p<0.001）。与其他组相比，经颈组的脓肿大小明显更大（非手术组、经口组和经颈组分别为5.72±8.93、13.51±14.74、18.36±16.05mm，p=0.009）。经颈组静脉注射抗生素的平均持续时间为9.77±3.27天，明显高于其他组（非手术组为5.49±3.28天，经口组为6.13±2.85天，p<0.001）。多因素分析显示，颌下脓肿（Exp（B）=5.254，p=0.012）是DNI手术治疗中经颈入路的唯一显著危险因素。
颌下间隙脓肿是小儿DNI患者治疗中经颈入路的唯一显著危险因素。
III级。
