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急性会厌炎患者的流行病学、临床表现、治疗及预后——基于中国北方一家三级医院的10年回顾性研究

Epidemiology, presentation, management and outcomes of patients with acute epiglottitis - A 10-year retrospective study based on a tertiary hospital in northern China.

作者信息

Fan Zhitao, Qiao Tong, Shi Sunan, Zhang Anqi, Liu Jingrui, Wang Yuetang, Liu Chaobing

机构信息

Department of Otolaryngology, Hebei Eye Hospital, No.399, East Quanbei Street, Xingtai, 054001, Hebei Province, China.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jan;282(1):333-340. doi: 10.1007/s00405-024-09042-9. Epub 2024 Oct 21.

Abstract

PURPOSE

This study aimed to explore the new clinical characteristics and trends of acute epiglottitis (AE) in northern China.

METHODS

A retrospective, observational study was conducted on patients diagnosed with AE between January 2014 and December 2023 at a single-center medical institution in northern China. The clinical profiles of patients with AE were investigated.

RESULTS

This study encompassed 366 AE patients (M: F = 1.79:1). The average age of the patients was 47.31 ± 13.18 years, and 33.4% patients had comorbidities. Common initial symptoms: sore throat (93.17%), dysphagia (48.09%), fever (10.65%). Dyspnea reported in 14.48%. AE incidence rose annually over a decade, with mild seasonal variations. Laryngoscopy remains the primary means of confirming AE. Almost all patients received intravenous antibiotic therapy, and 98% of them were also treated with corticosteroids. Emergency airway intervention needed in 2.73% (cricothyroidotomy: 0.54%; tracheotomy: 2.19%). Among all patients, 353 (96.44%) had a good prognosis, 1 death (0.27%) from cardiopulmonary arrest during tracheotomy, 1 anoxic encephalopathy (0.27%) after tracheotomy in the emergency room due to intubation failure.

CONCLUSION

The incidence rate of AE is on the rise. Even if airway intervention is rarely required, clinicians must maintain a high degree of vigilance and conduct early identification of risk factors and emergencies that could progress severe cases into life-threatening. Furthermore, the development of safe and efficacious management strategies is crucial to prevent catastrophic complications and safeguard patient lives.

摘要

目的

本研究旨在探讨中国北方地区急性会厌炎(AE)的新临床特征及趋势。

方法

对2014年1月至2023年12月在中国北方一家单中心医疗机构诊断为AE的患者进行回顾性观察研究。调查AE患者的临床资料。

结果

本研究纳入366例AE患者(男∶女 = 1.79∶1)。患者平均年龄为47.31±13.18岁,33.4%的患者有合并症。常见初始症状:咽痛(93.17%)、吞咽困难(48.09%)、发热(10.65%)。14.48%的患者报告有呼吸困难。AE发病率在十年间逐年上升,有轻微的季节性变化。喉镜检查仍是确诊AE的主要手段。几乎所有患者均接受静脉抗生素治疗,其中98%的患者还接受了糖皮质激素治疗。2.73%的患者需要紧急气道干预(环甲膜切开术:0.54%;气管切开术:2.19%)。所有患者中,353例(96.44%)预后良好,1例(0.27%)在气管切开术中因心肺骤停死亡,1例(0.27%)在急诊室气管切开术后因插管失败出现缺氧性脑病。

结论

AE发病率呈上升趋势。即使很少需要气道干预,临床医生也必须保持高度警惕,尽早识别可能使重症病例进展为危及生命的危险因素和紧急情况。此外,制定安全有效的管理策略对于预防灾难性并发症和保障患者生命至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5be6/11735524/f909abfc375e/405_2024_9042_Fig1_HTML.jpg

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