颈深部多间隙脓肿34例临床分析

Multi-space deep neck abscess:analysis of 34 cases

目的回顾性分析颈深部多间隙脓肿的临床特征、诊断、治疗和预后。方法总结分析2013年1月~2019年8月我院收治的34例颈深部多间隙脓肿患者的临床资料。结果32例行手术切开引流,2例保守治疗,感染来源以牙源性感染和异物常见,常见致病菌为链球菌,咽痛和颈部肿胀是最常见的临床表现,其中咽旁间隙和颈前间隙最常受累,术后并发症以低蛋白血症和电解质紊乱常见。该组患者33例治愈,1例死于感染性休克,随访1~3个月无复发。结论颈深部多间隙脓肿诊断明确后,及时有效的切开引流和合理抗生素的选择是治疗的关键,重视术后并发症的预防及处理,有利于该疾病的早期治愈。

OBJECTIVE To analyze the clinical manifestations,diagnosis,treatment and prognosis of multispace deep neck abscess.METHODS We retrospectively analyzed the data of 34 patients diagnosed with multi-space deep neck abscess between January 2013 and August 2019.RESULTS Antibiotic therapy was applied to all patients and 32 received incision and drainage of abscesses.The causes of multi-space deep neck abscess were odontogenic infection and foreign bodies.Bacterial culture of pus collected from all patients showed positive results in 11 cases with Streptococcus as the most common pathogen.The most common clinical characters were pharyngalgia and neck swelling.The most frequent affected site was the parapharyngeal and anterior cervical space.The most common complications were hypoproteinemia and electrolyte disturbance.All the patients were cured except 1 who died of septic shock.No recurrence were found within follow up of one to three months.CONCLUSION Early diagnosis,timely surgical incision and drainage,and broad-spectrum antibiotic treatment are the main method of treatment.In addition,effective prevention of complications is important for recovery.