Perrin A, Hareux S, Florant A, Baril C, Depondt J, Roulleau P
Service ORL, Hôpital Necker-Enfants-Malades, Paris.
Ann Otolaryngol Chir Cervicofac. 1987;104(8):625-31.
Principal etiologies in 54 patients with acute laryngeal dyspnea of infectious origin were epiglottitis (35 cases), glotto-subglottal laryngitis (8 cases) and adjacent infections (9 cases). These cases are reviewed together with the relevant published literature and various conclusions drawn. The affection is serious (35 deaths out of 425 cases in the literature), and requires careful examination, immediate treatment and routine hospital care under surveillance. Apart from cases where the condition of the patient necessitates urgent intubation, those cases with rapidly evolving signs over 24 hours must be admitted to intensive care since worsening of dyspnea can lead to delayed decompensation. Wide spectrum antibiotic therapy is necessary for patients with epiglottitis and adjacent infective ulcerations since many germs may be implicated, while for the always benign glotto-subglottal laryngitis Amoxicillin + clavulinic acid is sufficient.
54例感染性急性喉源性呼吸困难患者的主要病因是会厌炎(35例)、声门下喉炎(8例)和邻近部位感染(9例)。现将这些病例与相关已发表文献一同进行回顾并得出各种结论。这种疾病病情严重(文献中425例中有35例死亡),需要仔细检查、立即治疗并在监测下进行常规住院护理。除患者病情需要紧急插管的情况外,那些在24小时内症状迅速发展的病例必须入住重症监护病房,因为呼吸困难加重可能导致代偿延迟。会厌炎和邻近感染性溃疡患者需要使用广谱抗生素治疗,因为可能涉及多种病菌,而对于通常为良性的声门下喉炎,阿莫西林+克拉维酸就足够了。