严重颈深部化脓性感染临床诊疗分析

Clinical analysis in diagnosis and treatment of serious pyogenic infection in deep neck

目的 分析严重颈深部化脓性感染患者的临床特征、诊断和治疗。方法 回顾性分析2002年1月-2005年4月间22例严重颈深部化脓性感染患者的临床资料。结果 患者均为单侧发病，除表现为典型的感染症状外，同时伴有不同程度的呼吸困难、吞咽疼痛、张口受限、颈部进行性活动受限等。14例患者行脓液细菌培养，其中6例呈阳性。22例中14例经非手术抗感染治疗痊愈。8例在抗感染治疗同时进行脓肿切开引流术；术前1例行颈部正侧位摄片，7例行颈部增强CT，均显示脓肿形成；术后除1例因并发脑梗死及多脏器衰竭死亡外，其余均治愈出院。结论 影像学检查对颈深部化脓性感染术前诊断和系统性治疗具有重要意义。细菌培养为明确病因及制定有效的治疗方案提供了可靠依据。

Objective To explore the clinical features, diagnosis and treatment of serious pyogenic infection in deep neck. Methods From January 2002 to April 2005, the clinical data of 22 patients hospitalized with serious pyogenic infection in deep neck were collected and retrospectively analysed. Results All the patients suffered unilaterally. Besides the symptoms of infection, dyspnea, pain in swallowing, limitation of mouth opening and progressive limitation of cervical activity were presented. Bacterial cultivation were performed in 14 patients and positive results were detected in six. Fourteen of all the 22 patients were cured with antibiotics, and abscess incision drainage was carried out in the other eight. Preoperative cervical PA-LAT X-ray photography and contrast-enhanced CT scanning were performed on one and seven patients, respectively, all of which indicated the formation of abscess. All the patients were cured except one who died of cerebral infarction and muhiorgan dysfunction. Conclusion Imaging evaluation play＇s a significant role in the preoperative diagnosis and systemic treatment of serious pyogenie infection in deep neck. Bacterial cultivation provides reliable evidence for the etiopathogenisis and helps to make the effective treatment.