小儿急性咽后脓肿的诊断与治疗

Diagnosis and treatment of acute retropharyngeal abscesses in children

目的总结小儿急性咽后脓肿的诊治体会。方法回顾性分析8例小儿急性咽后脓肿患者的临床表现及治疗经过。结果5例首诊儿科并延误诊断。5例进行了颈部影像学检查,诊断准确率为100%。8例中6例经口内脓肿切开引流治愈;2例脓肿突然破裂,1例抢救后治愈,1例因全身感染中毒症状重而死亡。结论小儿急性咽后脓肿易被误诊,影像学检查有助提高诊断准确率,脓肿切开引流是最直接有效的治疗手段,倒提患儿是脓肿突然破裂时实用有效的急救措施。对于全身感染中毒症状较重的患儿,应及早行对症治疗。

Objective To summarize the diagnostic and therapeutic experience of acute retropharyngeal abscesses in children. Method A retrospective study was carried out among 8 cases. Results 5 cases were first misdingnosed by pediatrics doctors, then the 5 eases received neck imaging examination and the diagnosis rate was 100%. Among 8 cases, 6 cases were cured by intraoral drainage of the abscess and in 2 cases the abscess suddenly ruptured. One was cured by salvage and the other died because of exhaustion resulting from the severity of the infection. Conclusion Neck imaging is helpful for the diagnosis of acute retropharyngcal abscesses in children and incision and drainage of the abscesses is the most effective therapeutic method, When the abscess suddenly ruptured, turning the children upside down is an effective first-aid measurement. Early support and symptomatic treatment is necessary for prevention of exhaustion of patients resulting from severe infection.