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颈部深部感染:63例单中心分析

Deep neck infections: A single-center analysis of 63 cases.

作者信息

Kauffmann P, Cordesmeyer R, Tröltzsch M, Sömmer C, Laskawi R

机构信息

Department of Oral and Maxillofacial Surgery, University of Göttingen, Robert-Koch-Str 40, 37075 Göttingen, Germany,

出版信息

Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22(5):e536-e541. doi: 10.4317/medoral.21799.

DOI:10.4317/medoral.21799
PMID:28809368
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5694174/
Abstract

BACKGROUND AND PURPOSE

With the use of antibiotic therapy, the incidence of deep neck infections has decreased in recent decades. The aim of this investigation was to review the clinical course and the management of deep neck infections in our department, compare them to the experiences of the common literature and identify predisposing factors for lethal complications.

MATERIAL AND METHODS

In this single-center analysis, 63 patients with deep neck infections were treated surgically. The following clinical data were analyzed and compared: age, gender, laboratory data, spatial manifestation, therapeutic modalities, comorbidities, length of hospitalization and complications.

RESULTS

There was a predominance of male patients (58.7%) and a mean age of 57.9 years. The most common symptoms at diagnosis were sore throat (96.8%) and neck swelling (92.0%). Cardio/pulmonary diseases and diabetes mellitus were the most common comorbidities. There was a significantly longer hospital stay for patients with diabetes mellitus. The most common manifestation was a parapharyngeal abscess in 24 patients (38.1%), followed by peri-/retrotonsillar infections in 19 patients (30.2%). In 29 patients, a multiple space infection was observed, with a significantly longer duration of hospitalization and a higher rate of complications. The main life-threatening complication was the development of airway obstruction in 20 patients (31.7%), who all received a tracheostomy. The duration of hospitalization for patients with complications was significantly longer.

CONCLUSION

Close attention must be paid to the management of patients with deep neck infections, especially patients with diabetes mellitus and cardio/pulmonary diseases or patients with multiple space infections.

摘要

背景与目的

近几十年来,随着抗生素治疗的应用,颈部深部感染的发病率有所下降。本研究的目的是回顾我院颈部深部感染的临床病程及治疗情况,与常见文献中的经验进行比较,并确定致死性并发症的诱发因素。

材料与方法

在这项单中心分析中,63例颈部深部感染患者接受了手术治疗。对以下临床数据进行了分析和比较:年龄、性别、实验室数据、感染部位、治疗方式、合并症、住院时间和并发症。

结果

男性患者占多数(58.7%),平均年龄为57.9岁。诊断时最常见的症状是咽痛(96.8%)和颈部肿胀(92.0%)。心肺疾病和糖尿病是最常见的合并症。糖尿病患者的住院时间明显更长。最常见的感染部位是咽旁脓肿24例(38.1%),其次是扁桃体周围/扁桃体后感染19例(30.2%)。29例患者出现多间隙感染,住院时间明显更长,并发症发生率更高。主要的危及生命的并发症是20例患者(31.7%)发生气道梗阻,均接受了气管切开术。有并发症的患者住院时间明显更长。

结论

必须密切关注颈部深部感染患者的治疗,尤其是糖尿病患者、心肺疾病患者或多间隙感染患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dd/5694174/9e78fc3ce287/medoral-22-e536-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dd/5694174/ea5645466d83/medoral-22-e536-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dd/5694174/9e78fc3ce287/medoral-22-e536-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dd/5694174/ea5645466d83/medoral-22-e536-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50dd/5694174/9e78fc3ce287/medoral-22-e536-g002.jpg

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