Jicman Stan Daniela, Sârbu Nicolae, Rebegea Laura-Florentina, Crăescu Mihaela, Niculeț Elena, Țuța Maria-Daniela, Nechita Aurel, Nicolescu Alin Codruț, Tatu Alin Laurențiu
Department of Otorhinolaryngology, "Sfântul Apostol Andrei" Emergency Clinical Hospital, 800578 Galați, Romania.
Biomedical Doctoral School, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800010 Galați, Romania.
Life (Basel). 2023 Feb 15;13(2):535. doi: 10.3390/life13020535.
As medical-surgical emergencies, regardless of the causal agent, deep cervical space suppurations are not only a diagnostic challenge, but also a therapeutic one. In some cases, in spite of proper therapeutic measures, extremely severe complications can develop. A 5-year retrospective study (2016-2020) was conducted on a group of 107 patients suffering from cervical suppurations, being hospitalized and treated in the ENT Clinic of the "Sf. Apostol Andrei" Emergency County Hospital of Galați. This research is a clinical-statistical study based on the experience of this ENT clinic and was carried out based on the analysis of the patients' medical records. Descriptive analysis' statistical methods of the data series collected from the clinical observation sheets were used, with the patients' informed consent for the processing of the aforementioned data, with the agreement of the Ethics Commission of the Emergency Clinical Hospital "Sf. Apostol Andrei" Galați and the College of Physicians Galați, România. The patients' clinical and multidisciplinary treatment features included in the study group are presented. The results highlight the clinical particularities of deep cervical space suppurations treatment, including under COVID-19 impact, or with other comorbidities, having consequences on the case mix index increase or directly on the costs, admittance duration and the clinical status of the patient at discharge. The conclusions of the clinical study are based on the fulfillment of the research objectives in terms of treatment and symptomatology of deep cervical space suppurations and under the impact of comorbidities (global health crisis and pandemic, triggering of comorbidities due to health care access difficulty in the context of anti-COVID-19 government-implemented measures and the infection-rate that overburdened the medical system in the early period of the pandemic). Individualized treatment of deep cervical space suppurations is recommended to be approached multidisciplinary. Of particular importance is early diagnosis combined with prompt and correctly instituted multidisciplinary treatment. In this context, an appropriate medical measure that we recommend is patient health education, as it was observed in the clinical study: most times, patients address medical services with advanced disease, hence the generally unfavorable prognosis and outcome (about 25% of patients develop unfavorable prognosis and 4% die).
作为外科急症，无论病因如何，颈部深部间隙化脓不仅是诊断上的挑战，也是治疗上的挑战。在某些情况下，尽管采取了适当的治疗措施，仍可能出现极其严重的并发症。对加拉茨“圣使徒安德烈”县急救医院耳鼻喉科收治并治疗的107例颈部化脓患者进行了一项为期5年（2016 - 2020年）的回顾性研究。本研究是一项基于该耳鼻喉科临床经验的临床统计研究，基于对患者病历的分析开展。使用从临床观察表收集的数据系列的描述性分析统计方法，在获得患者对上述数据处理的知情同意后，经加拉茨“圣使徒安德烈”急救临床医院伦理委员会和罗马尼亚加拉茨医师协会同意进行。介绍了研究组患者的临床和多学科治疗特点。结果突出了颈部深部间隙化脓治疗的临床特殊性，包括在新冠疫情影响下，或伴有其他合并症时，对病例组合指数增加或直接对成本、住院时间和患者出院时的临床状况产生的影响。临床研究的结论基于在颈部深部间隙化脓的治疗和症状学方面以及合并症影响下（全球健康危机和大流行、在政府实施的抗击新冠措施背景下因医疗服务获取困难引发合并症以及疫情初期感染率使医疗系统不堪重负）实现研究目标。建议对颈部深部间隙化脓进行多学科的个体化治疗。特别重要的是早期诊断并及时正确地开展多学科治疗。在此背景下，我们推荐的一项适当医疗措施是患者健康教育，正如在临床研究中所观察到的：大多数情况下，患者在疾病进展到晚期才就医，因此总体预后和结局不佳（约25%的患者预后不良，4%的患者死亡）。
