36例颈深部感染的临床分析.docVIP

36例颈深部感染的临床分析 张大为 陈仁杰 [摘要] 目的 探讨颈深部感染患者的临床特征、诊断及治疗方法。方法 对2005年1月～2010年12月收治的36例颈深部感染患者的临床资料进行回顾性分析。结果 颈深部感染伴有扁桃体炎20例，伴有牙源性感染9例，糖尿病伴感染患者8 例。不合并糖尿病患者病程为3d~2周，平均6d，合并糖尿病患者病程10d~3周，平均14d。19例脓液细菌培养，其中5例培养阳性。36例颈深部感染患者中17例未形成脓肿的患者经大剂量抗生素全身用药治疗均治愈；其他19例(52.7％)患者通过CT检查确定脓肿形成，其中8例糖尿病患者有7例患者有脓肿形成，采用脓肿切开引流术加多联抗生素联合治疗，36例患者痊愈出院，伤口愈合好，无并发症。结论 颈深部感染继发于咽部或口腔感染引起。与不合并糖尿病患者相比，合并糖尿病患者疗程长、进展快，较易发生脓肿及严重并发症。CT检查应成为深颈部感染患者的常规检查，颈深部感染一经确诊：应合理应用抗生素；对于脓肿形成的患者，应尽早行脓肿切开引流术；合并糖尿病积极控制血糖，是控制感染的重要条件。 [关键词]感染；颈深部； 临床分析 Clinical Aanalysis in Diagnosis and Treatment of 36 Serious Infection in Deep Neck ZHANG Dawei CHEN Renjie Department of Otolaryngology,the Second Hospital Affiliated to Nanjing Medical University,Nanjing 210029, China [Abstract] Objective To review the clinical features，diagnosis and treatment of serious deep neck infection．Methodspatients treated for deep neck infection at the department of otolaryngology of the second hospital affiliated to Nanjing medical university during the period from January 2005 to December 2010 were collected and retrospectively reviewed．Results Of the 36 patients recruited, 20 cases companion with peritonsillar inflammation, nine cases were companion with dental infection. With systemic underlying diseases: 8 patients were diabetes mellitus. The duration of admission without diabetes mellitus ranged from 3 days-2 weeks with an average of 6 days, The duration of admission with diabetes mellitus ranged from 10 days-3weeks with an average of 14 days. Among 19 cases of pus bacterial cultivation,5 cases were positive.17cases of neck deep space infection in 36 patients without abscess formation in patients were treated by high-dose systemic antibiotic drug treatment; Performed with computed tomography ,the other 19 patients(52.7％) were treated by abscess incision and drainage after the treatment of antibiotics, the wound healed well without complications. Conclusion Dental infection and peritonsillar infections were the most common cause of deep neck i