颈部深筋膜间隙感染27例临床分析

Deep neck interfascial space infection: clinical analysis of 27 cases

目的了解颈部深筋膜间隙感染的临床特性和探讨其治疗经验。方法复习病历并回顾性分析2005年1月～2011年12月我院耳鼻咽喉科及颌面外科收治的27例颈部深筋膜间隙感染患者的临床资料。结果颈部深筋膜间隙感染的病因来源分别为:牙源性6例,咽及食管异物15例(其中伴有糖尿病7例),上呼吸道感染伴急性化脓性扁桃体炎3例,医源性1例,原因不明2例。24例治愈出院,3例死亡。结论颈部深筋膜间隙感染因为可蔓延多间隙而使病情复杂化,一经确诊应积极治疗。重点防止发生呼吸道阻塞、血管破裂、上纵隔感染等严重并发症,同时需加强伴有糖尿病等全身疾病患者的个体化治疗。

Objective To understand the clinical characteristics and discuss the treatment experience of deep neck interfascial space infection.Methods A respective review was conducted in 27 cases who were diagnosed as deep neck interfascial space infection in department of otolaryngology and dentofacial surgery of this hospital from Jan.2005 to Dec.2011.Results The causes of deep neck interfascial space infection were tooth diseases（6 cases）,foreign bodies in pharynx and esophagus（15 cases,including 7 cases with diabetes）,upper respiratory infection and acute tonsillitis（3 cases）,iatrogenic cause（1 case）,uncertain cause（2 cases）.24 cases were cured and 3 cases died.Conclusion Once deep neck interfascial space infection is diagnosed,early treatment is very important to improve the cure rate because of it＇s characteristics of multiple space spread.To control the complications such as the occurrence of airway obstruction,vascular rupture,mediastinal infection and strengthen the individual treatment of the systemic disease such as diabetes patients are very important.