220例颈深间隙感染临床分析

Clinical analysis of 220 cases of deep neck space infection

目的探讨颈深间隙感染患者临床特征、治疗体会和经验教训,提高对颈深间隙感染的诊疗水平。方法回顾性分析220例颈深间隙感染患者临床特征、治疗措施、预后资料。结果220例患者中,98例颈深间隙蜂窝织炎患者经单纯抗感染和对症支持治疗治愈88例,10例进展为颈深间隙脓肿,并经进一步脓肿穿刺或切开引流治愈。122例颈深间隙脓肿患者经抗感染联合脓肿穿刺或切开引流和对症支持治疗,其中12例结核感染性脓肿联合抗结核治疗,25例因并发严重喉阻塞行气管切开治疗,最终118例治愈,4例因严重并发症死亡。结论颈深间隙感染病情危重,有效抗感染联合脓肿穿刺或切开引流是治疗成功的关键,结核等特殊性感染需联合抗结核等药物治疗。及时正确处置合并症与并发症,可减少致死致残率。

Objective This study aimed to explore the clinical characteristics,treatment experience,and lessons learned in the treatment of DNI and improve DNI diagnosis and treatment.Methods The clinical characteristics,treatment measures,and prognosis of 220 patients with DNI were retrospectively analyzed.Results Among the 220 patients,98 with deep cervical space cellulitis were cured by simple anti-infection and symptomatic supportive treatment in 88 cases,whereas 10 cases progressed to deep cervical space abscesses that were cured by further abscess puncture or incision and drainage.The other 122 patients with deep neck space abscesses were treated with anti-infection combined with abscess puncture or incision and drainage and symptomatic supportive treatment.Among them,12 cases of tuberculosis infectious abscess were administered anti-tuberculosis treatment,25 were treated with tracheotomy due to complicated severe laryngeal obstruction,and 118 healed.A total of 4 patients died of severe complications.Conclusion DNI is a critical illness.Effective anti-infective measures combined with abscess puncture or incision and drainage is the key to successful treatment.Tuberculosis or other special infections require combination anti-tuberculosis and other special treatments.The timely and correct treatment of comorbidities and complications can reduce mortality and disability rates.