ICU内重症腐败坏死性口底蜂窝织炎回顾性分析

Retrospective analysis of Ludwig's angina in the intensive care unit

目的分析重症监护室(ICU)内重症腐败坏死性口底蜂窝织炎(LA)患者的临床特点及治疗结局。方法回顾性分析2013年1月-2021年12月兰州大学第一医院ICU收治的重症LA患者的临床特征,运用Log-Rank检验分析下行性坏死性纵隔炎(DNM)对ICU住院时长及总住院时长的影响。结果ICU内重症LA患者入ICU的主要原因有脓毒症、手术和呼吸衰竭。APACHEⅡ评分和SOFA评分分别为(12.67±3.50)、(3.55±3.04)分。有41例患者(97.62%)接受机械通气治疗,27例(64.29%)患者细菌培养阳性,共分离出15种细菌。平均ICU住院时长为(6.52±12.29)d,平均总住院时长为(24.50±14.60)d,ICU内LA的死亡率为9.52%。与不存在DNM的患者相比,存在DNM的患者的ICU住院时长明显延长。结论ICU内重症LA患者全身症状重,并发症发生率高,住院时间长。

Objective To analyze the clinical characteristics and outcomes of patients with Ludwig's angina(LA)who were admitted to the intensive care unit(ICU).Methods All the patients with LA who were admit-ted to the ICU of The First Hospital of Lanzhou University from January 2013 to December 2021 were retrospectively reviewed and their clinical characteristics analyzed.The Log-Rank test was used to analyze the impact of descending necrotizing mediastinitis(DNM)on the hospital/ICU length of stay(LOS).Results The main reason for ICU admission was sepsis,surgical and respiratory failure.The mean APACHEⅡand SOFA scores were 12.67±3.50 and 3.55±3.04,respectively.Forty-one patients(97.62%)received respiratory support.Twenty-seven(64.29%)had positive bacterial culture results.Fifteen bacterial strains were detected.The mean ICU LOS was 6.52±12.29 days,and 24.50±14.60 days in the hospital.The ICU mortality rate was 9.52%.Compared with patients with LA without DNM,those with DNM had longer ICU LOS.Conclusion The LA patients in ICU had serious systemic symptoms,high incidence of complications and long hospitalization time.