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[成人咽喉部白喉的诊断]

[Diagnosis of pharyngeal and laryngeal diphtheria in adults].

作者信息

Grigorév G M, Kortev A I, Shemiakina E K, Shmatova N K

出版信息

Vestn Otorinolaringol. 1995 Mar-Apr(2):31-3.

PMID:7785153
Abstract

142 adults with pharyngeal and laryngeal diphtheria were registered in Yekaterinburg in 1993. Of them, 136 patients recovered and 6 died. The analysis of the clinical features and diagnostic errors showed that subjects with chronic visceral diseases and alcoholics are more likely to have poor prognosis of diphtheria. Diphtheria manifested primarily with edema followed by infiltration of the mucosa, with appearance of thin transparent furs, tenderness of cervical regional lymph nodes. The typical greyish-brown thick and firm false membranes occurred only in the late stage of the disease. The features of the diphtheric croup in the adults complicated the diagnosis. These were, unlike croup in children, the vagueness of the stages of this syndrome, rapid involvement of the trachea and bronchi, mixed type of dispnea and delirious state in alcoholics. It is necessary to set up the duty of ENT specialists in the diagnostic departments of the infectious hospitals for repeated endoscopic and bacteriologic examinations of the diphtheria suspects.

摘要

1993年,叶卡捷琳堡登记了142例咽喉白喉成人患者。其中,136例患者康复,6例死亡。对临床特征和诊断错误的分析表明,患有慢性内脏疾病的患者和酗酒者白喉预后较差的可能性更大。白喉主要表现为水肿,随后是黏膜浸润,出现薄而透明的舌苔,颈部区域淋巴结压痛。典型的灰棕色厚而坚实的假膜仅出现在疾病后期。成人白喉性喉炎的特征使诊断复杂化。与儿童喉炎不同,该综合征各阶段不明确,气管和支气管迅速受累,呼吸困难类型混合,酗酒者出现谵妄状态。有必要在传染病医院的诊断科室安排耳鼻喉科专家值班,以便对疑似白喉患者进行反复的内镜检查和细菌学检查。

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