Fiorella Maria Luisa, Greco Paolo, Madami Luigi Maria, Giannico Orazio Valerio, Pontillo Vito, Quaranta Nicola
Unit of Otorhinolaryngology, Department of Biomedical Sciences, Neurosciences and Sense Organs, University of Bari, Italy.
Section of Hygiene, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
Acta Otorhinolaryngol Ital. 2020 Oct;40(5):332-337. doi: 10.14639/0392-100X-N0790.
Deep neck space infections (DNSIs) are a group of infective suppurative diseases involving deep neck spaces and cervical fascia. Necrotising and septic evolutions are rare, but severe complications can dramatically affect the prognosis and should be promptly managed. Clinical examination often has low sensitivity, although instrumental diagnosis may delay te treatment. We investigated two laboratory tools, LRINEC (Laboratory Risk Indicator for the Necrotizing fasciitis) and NLR (neutrophil to lymphocyte ratio), in the expectation to find a rapidly available predictive indicator that may help in distinguishing necrotising complications and/or systemic septic involvement.
A retrospective observational cohort study was performed on 118 patients who had underwent surgical treatment for DNSIs at our Surgical Unit. LRINEC, NLR and the product LRINEC x NLR were calculated.
Statistical analysis showed that these scores may have utility in rapidly predicting the risk of necrotising fasciitis and systemic involvement at an early diagnostic stage.
Further studies with a larger cohort may be necessary in order to increase the sensitivity and specificity.
颈部深部间隙感染（DNSIs）是一组累及颈部深部间隙和颈筋膜的感染性化脓性疾病。坏死性和脓毒症性进展较为罕见，但严重并发症会显著影响预后，应及时处理。临床检查的敏感性通常较低，尽管影像学诊断可能会延误治疗。我们研究了两种实验室指标，即坏死性筋膜炎实验室风险指标（LRINEC）和中性粒细胞与淋巴细胞比值（NLR），期望找到一种可快速获得的预测指标，以帮助区分坏死性并发症和/或全身脓毒症累及情况。
对在我们外科接受DNSIs手术治疗的118例患者进行了一项回顾性观察队列研究。计算了LRINEC、NLR以及LRINEC×NLR的值。
统计分析表明，这些评分在早期诊断阶段可能有助于快速预测坏死性筋膜炎和全身累及的风险。
可能需要进行更大样本量队列的进一步研究，以提高敏感性和特异性。
