106例成人急性会厌炎患者的回顾性研究

A retrospective review about 106 cases of acute epiglottitis in adults

目的:回顾性分析我院在过去7年里被确诊为急性会厌炎的106例患者临床特征、处理以及治疗结果。方法:选取2008-07-2015-06于我院就诊并被诊断为急性会厌炎的患者。急性会厌炎的诊断标准为间接喉镜或纤维喉镜下可见的发炎肿胀的会厌。结果:共106例患者被确认参与此次研究。共21例患者(19.8%)有伴随疾病,其中糖尿病(11%)最为常见。3例患者有鼻咽癌病史,3例患者既往有急性会厌炎病史,属于反复发作。大多数(94%)的患者以喉咙疼痛作为主诉前来就诊。对15例患者进行血培养且结果均为阴性。头孢噻肟和甲硝唑的组合使用是最常见的经验性抗生素治疗方案。7例患者需要积极的呼吸道干预(6例行气管插管,1例插管失败行紧急气管切开)。无死亡病例报告。结论:成人急性会厌炎通过抗菌药物治疗、密切监测和选择性气道干预,其预后良好。

Objective：Acute epiglottitis in adult is a potentially life-threatening condition that may be underdiagnosed.The present study reports the clinical features,management and patient outcomes in Wuhan No.1hospital over a seven-year period.Method：All adult patients aged 18 years or above admitted to Tuen Mun Hospital between July 2008 and June 2015 with the diagnosis of acute epiglottitis were included in this retrospective study.The diagnosis of acute epiglottitis was established by direct visualisation of inflamed epiglottis during laryngoscopic examination.Result：106patients were identified.A total of 21patients（20%）had co-morbidities,with diabetes mellitus（11%）being the most common.Five patients had a history of nasopharyngeal carcinoma and three patients had a previous history of acute epiglottitis.The majority（94%）of patients presented with sore throat as their major complaint.Blood cultures were collected from 15 patients and all were negative.A combination of cefotaxime and metronidazole was the most common empirical antibiotic regimen prescribed.Seven patients required active airway intervention（six with endotracheal intubation and one failed intubation with emergency tracheostomy performed）.No mortality was reported.Conclusion：Acute epiglottitis in adults is not a rare entity and vigilance for this condition is needed.In general,the prognosis is good with antimicrobial therapy,close monitoring and selective airway intervention.