Wang Y, Chen X M, Zhang H, Li D J, Wang Q, Song X C
Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Apr 7;55(4):358-362. doi: 10.3760/cma.j.cn115330-20190911-00574.
To explore the clinical experience in care for deep neck infection (DNI) and to analyze the factors influencing surgical treatment outcome. A retrospective analysis was conducted on 61 patients with DNI admitted to the Department of Otorhinolaryngology Head and Neck Surgery of Yantai Yuhuangding Hospital from March 2013 to April 2019, including 33 males and 28 females, aged from 6 months to 81 years with a median age of 49 years. Patients were divided into two groups, 31 cases with localized infection (neck abscess) in Group A and 30 cases with diffuse infection (neck necrotizing fasciitis) in Group B. Patients in two groups were compared for sex, age, hospital stay, diabetes, tracheostomy, drainage methods, mediastinal infection, and pathogenic bacteria. The influence of different drainage methods on hospital stay in Group A was analyzed. SPSS 25.0 software was used for statistical analysis. Of the 61 patients, 45 patients underwent surgical incision and drainage (21 cases in Group A and 24 cases in Group B), 23 patients underwent ultrasound-guided fine needle aspiration (UG-FNA) and catheter drainage (10 cases in Group A and 13 cases in Group B), and 7 patients in Group B were treated with both drainage methods. Pathogens were cultured in 31 cases (50.82%). There were significant differences in hospital stay, drainage method and mediastinal infection (χ(2) values were 26.890, 8.687 and 6.035, respectively, <0.05), but no significant difference was found in sex, age, diabetes, tracheotomy and pathogenic bacteria (χ(2) values were 0.157, 3.685, 2.434, 3.631 and 0.807, respectively, >0.05) between the two groups. There was no significant difference in hospital stay between two drainage methods in patients in Group A (χ(2)=1.560, >0.05). There were significant differences in hospital stay, drainage method and mediastinal infection between patients with localized infection and diffuse infection, as diffuse infection is often associated with serious complications. UG-FNA and catheter drainage is an optional method for the treatment of localized infection, with minimal invasion and no influence on hospital stay.
探讨颈部深部感染(DNI)的护理临床经验,并分析影响手术治疗效果的因素。对2013年3月至2019年4月在烟台毓璜顶医院耳鼻咽喉头颈外科住院的61例DNI患者进行回顾性分析,其中男性33例,女性28例,年龄6个月至81岁,中位年龄49岁。患者分为两组,A组31例为局限性感染(颈部脓肿),B组30例为弥漫性感染(颈部坏死性筋膜炎)。比较两组患者的性别、年龄、住院时间、糖尿病、气管切开术、引流方法、纵隔感染及病原菌情况。分析A组不同引流方法对住院时间的影响。采用SPSS 25.0软件进行统计分析。61例患者中,45例行手术切开引流(A组21例,B组24例),23例行超声引导下细针穿刺抽吸(UG-FNA)及置管引流(A组10例,B组13例),B组7例采用两种引流方法联合治疗。31例(50.82%)进行了病原菌培养。两组患者在住院时间、引流方法及纵隔感染方面差异有统计学意义(χ²值分别为26.890、8.687和6.035,P<0.05),但在性别、年龄、糖尿病、气管切开术及病原菌方面差异无统计学意义(χ²值分别为0.157、3.685、2.434、3.631和0.807,P>0.05)。A组患者两种引流方法的住院时间差异无统计学意义(χ²=1.560,P>0.05)。局限性感染和弥漫性感染患者在住院时间、引流方法及纵隔感染方面差异有统计学意义,因为弥漫性感染常伴有严重并发症。UG-FNA及置管引流是治疗局限性感染的一种可选方法,具有微创性且不影响住院时间。