急性腐败坏死性口底蜂窝织炎30例临床分析

Acue rotten necrotic fascitis in the mouth floor:analysis of 30 cases

目的：总结急性腐败坏死性口底蜂窝织炎的诊治经验。方法：对1995～2004年收治的30例急性腐败坏死性口底蜂窝织炎的临床资料进行回顾性分析。结果：30例中牙源性20例，其它10例，5例合并有糖尿病。26例作了脓液细菌培养，15例（57．69％）为阳性。经过切开置管引流、全身支持、大剂量敏感抗生素治疗，治愈23例（76．7％），死亡7例（23．3％）中6例并发中毒性休克死亡（4例为合并有糖尿病），1例放弃治疗死于窒息。结论：急性腐败坏死性口底蜂窝织炎病例的诊治关键是早期识别，维持呼吸道通畅，及时切开引流，使用敏感抗生素、有效控制其它伴发疾病、全身对症等综合治疗。重视对并发症的认识及处理，提高临床治愈率。

Objective： To analyze the clinical character, diagnosis and treatment experience of Acue rotten necrotic fascitis in the mouth floor. Method：A respective review was conducted in 30 cases who were diagnosed as having Acue rotten necrotic mouth floor faseitis in this hospital from Jan 1995 to Dec 2004. Result. the causes of the faseitis were tooth diseases（20 cases）, other cause （1 cases） . Among them, diabetes mellitus （5 cases） . 26 cases of pus bacterial cultivation, 15（57.69% ）cases were positive. By different ways of drainage including beforehand retaining tracheal intubation , early wide the mouth floor multiple incision, large dosage of antibiotics and support therapy, 23 cases were cured（76.67 % ） and 7eases died（23.33% ） . six died of infective shock,among them diabetes mellitus（4 cases） . one of obstructive asphyxia. Conclusion：The key of diagnosis and treatment of Acue rotten necrotic fascitis in the mouth floor is recognized early, early tracheal intubation , surgial drainage in time, appropriate use of antibiotics, support therapy and control of complications and accompanying diseases are very important to improve the cure rate.