类固醇在儿童咽旁和咽后脓肿保守治疗中的作用。
Role of steroids in conservative treatment of parapharyngeal and retropharyngeal abscess in children.
机构信息
Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 3301, Oviedo, Spain.
Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.
出版信息
Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5331-5338. doi: 10.1007/s00405-022-07423-6. Epub 2022 Jun 29.
PURPOSE
To characterize the clinical features and outcomes of pediatric patients with retropharyngeal (RPA) or parapharyngeal abscesses (PPA) managed only with medical treatment and showing the importance of early symptoms and imaging studies in the diagnosis of deep neck space infections (DNIs) in children.
METHODS
A retrospective analysis of all patients diagnosed with RPA and PPA between 2007 and 2017 was performed in Hospital Universitario Central de Asturias.
RESULTS
30 children were identified, with 11 RPA and 19 PPA. 23 children (76.7%) were under 5 years old, and all were treated with intravenous amoxicillin/clavulanic acid and corticosteroids. Torticollis and fever were present in all patients. The mean length of hospital stay was 7.5 days. There were no complications associated.
CONCLUSION
DNIs can be treated in a conservative way, reserving the surgical drainage for cases with a complication associated (airway compromise, lack of response to antibiotic therapy, immunocompromised patients). Treatment with intravenous antibiotics and corticosteroids is a safe option, reducing the duration of symptoms and the length of hospital stay.
目的
描述仅接受药物治疗且表现为后咽部（RPA）或咽旁间隙脓肿（PPA）的儿科患者的临床特征和结局，强调早期症状和影像学检查对儿童深部颈部间隙感染（DNI）诊断的重要性。
方法
对 2007 年至 2017 年间在阿斯图里亚斯中央大学医院诊断为 RPA 和 PPA 的所有患者进行回顾性分析。
结果
共发现 30 例患儿，其中 11 例为 RPA，19 例为 PPA。23 例（76.7%）患儿年龄小于 5 岁，所有患儿均接受静脉用阿莫西林/克拉维酸和皮质类固醇治疗。所有患者均存在斜颈和发热。平均住院时间为 7.5 天。无相关并发症。
结论
DNI 可采用保守治疗，仅对存在相关并发症（气道阻塞、抗生素治疗反应不佳、免疫功能低下患者）的病例进行手术引流。静脉用抗生素和皮质类固醇治疗是一种安全的选择，可缩短症状持续时间和住院时间。
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