外科理论与实践

外科理论与实践 ›› 2019, Vol. 24 ›› Issue (02): 135-140.doi: 10.16139/j.1007-9610.2019.02.011

• 论著 • 上一篇    下一篇

颈深部间隙感染的综合治疗（附12例报告）

杨晨1a, 孙祥2,*, 丁家增1b, 丁晓毅1c, 张华1d, 王士礼1a, 蔡昌枰1a   

  1. 1.上海交通大学医学院附属瑞金医院 a.耳鼻咽喉科,b.外科,c.放射介入科,d.放射科,上海 200025;
    2.苏州眼耳鼻喉科医院耳鼻咽喉科,江苏 苏州 215006
  • 收稿日期:2018-12-03 出版日期:2019-03-25 发布日期:2019-04-25
  • 通讯作者: 蔡昌枰,E-mail: billycai56@hotmail.com
  • 作者简介:*:共同第一作者

Comprehensive treatment of deep neck space infection: a report of12cases

YANG Chen1a, SUN Xiang2*, DING Jiazeng1b, DING Xiaoyi1c, ZHANG Hua1d, WANG Shili1a, CAI Changping1a   

  1. 1a. Department of Otolaryngology, 1b. Department of Surgery, 1c. Department of Radiological Intervention, 1d. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
    2. Department of Otolaryngology, Suzhou EENT Hospital, Jiangsu Suzhou 215006, China
  • Received:2018-12-03 Online:2019-03-25 Published:2019-04-25

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摘要： 目的 探讨颈深部间隙感染（deep neck space infection, DNI）的综合治疗。方法 回顾性分析瑞金医院耳鼻咽喉科2005年1月至2018年9月间收治12例DNI病人的临床资料和诊疗方法。结果 12例病人中,4例合并糖尿病,咽痛为最多见首发症状。所有病人均经颈部CT检查明确DNI诊断。咽旁间隙是最多受累的颈深部间隙。8例因脓肿形成行颈部切开脓肿引流,其中1例切开引流合并CT引导下经皮穿刺脓肿引流。3例同时行气管切开。所有病人均予以静脉抗生素治疗,5例留置鼻胃管营养。12例病人平均住院时间（29.1±7.3） d,11例治愈,1例死亡。结论 早期足量全身使用广谱抗生素、适时选择恰当的引流手术、气道管理和营养支持是DNI综合治疗的关键。

关键词: 颈深部感染, 脓肿, 手术

Abstract: Objective To investigate the comprehensive treatment of deep neck space infection. Methods The clinical data of 12 patients with deep neck space infection were retrospectively analyzed in Department of Otolaryngo-logy, Ruijin Hospital from January 2005 to September 2018. Results Four cases had concurrent diabetes mellitus and pharyngalgia was the most common and first-episode symptom. All patients were diagnosed as deep neck space infection by neck CT scan. The parapharyngeal space was the most involved among deep neck spaces. Eight patients underwent abscess dissection including one case with dissection in one space and CT-guided percutaneous aspiration and drainage in another space. Three patients underwent tracheotomy simultaneously. Intravenous antibiotics was given all patients and nasogastric feeding in 5 patients. Hospital stay was (29.1± 7.3) days. Totally 11 patients were cured and 1 patient died. Conclusions It is indicated in this study that early and adequate use of broad-spectrum antibiotics, timely drainage, airway management and nutritional support are the key to treat deep neck space infection comprehensively.

Key words: Deep neck infection, Abscess, Surgery

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