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咽旁脓肿:单纯抗生素治疗还是开放手术引流?

Parapharyngeal Abscess: Antibiotic-only or Open Surgical Drainage?

作者信息

Zhao Xiaoyun, Ma Jingru, Wu Xiufa, Wei Chunsheng

机构信息

Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose & Throat Hospital, Fudan University, Shanghai, PR China.

出版信息

Ear Nose Throat J. 2023 Jul 18:1455613231185041. doi: 10.1177/01455613231185041.

Abstract

Many problems of parapharyngeal abscess (PPA), such as etiology, predisposing factors, and therapeutic methods, are still controversial. We aim to investigate the characteristics of PPA to better understand the therapeutic effects of the disease. We retrospectively collated the medical record reviews of 49 PPA patients who were treated as PPA inpatients when a patient was hospitalized and diagnosed with PPA, and empiric antibiotics were used. Only if the drug treatment was ineffective, the abscess was large, or the disease continued to progress, and surgical treatment was adopted. In total, 49 patients who met the research criteria were identified. Streptococcus was the most common organism in PPA patients. The morbidity of diabetes in PPA patients was higher than the prevalence of diabetes in the overall population. Interestingly, the length of hospital stay was shorter in the antibiotic-only group than in the surgery group ( < 0.05). Furthermore, the duration from onset to treatment in the antibiotic-only group was shorter than in the surgery group. Our treatment protocol is effective. Antibiotic-only method is also recommended for the PPA which was effective for the empiric antibiotics and localized. Early diagnosis and treatment of PPA could ultimately reduce the severity of PPA.

摘要

咽旁脓肿(PPA)的许多问题,如病因、诱发因素和治疗方法,仍存在争议。我们旨在研究PPA的特征,以更好地了解该疾病的治疗效果。我们回顾性整理了49例PPA患者的病历资料,这些患者在住院时被诊断为PPA并作为PPA住院患者接受治疗,采用经验性抗生素治疗。只有在药物治疗无效、脓肿较大或疾病持续进展时,才采用手术治疗。总共确定了49例符合研究标准的患者。链球菌是PPA患者中最常见的病原体。PPA患者的糖尿病发病率高于总体人群中的糖尿病患病率。有趣的是,单纯抗生素治疗组的住院时间比手术组短(<0.05)。此外,单纯抗生素治疗组从发病到治疗的时间比手术组短。我们的治疗方案是有效的。对于对经验性抗生素有效且局限的PPA,也推荐单纯使用抗生素的方法。PPA的早期诊断和治疗最终可以降低PPA的严重程度。

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