颈深间隙感染:一项关于手术风险因素的回顾性队列研究

Deep neck space infections:a retrospective cohort study of surgical risk factors

目的探索影响颈深间隙感染(deep neck space infections, DNSIs)治疗方式的风险因素, 为制订恰当的早期方案提供指导。方法对2013年3月至2021年2月青岛大学附属医院耳鼻咽喉头颈外科收治的DNSIs住院患者进行回顾性队列研究。根据是否接受手术, 将其分为手术组和非手术组。收集的信息包括人口学资料、疾病相关的症状体征、诊疗经过、全身性合并症、影像数据和实验室指标。数据处理采用假设检验、单因素Logistic回归分析和多因素Logistic回归分析。结果共纳入61例患者, 其中男37例, 女24例, 年龄6~96岁。手术组35例(57.4%), 非手术组26例(42.6%)。经多因素分析发现:患者颈部运动障碍(OR=0.03, 95%CI:0.00~0.24)、吞咽困难(OR=0.10, 95%CI:0.02~0.72)、血清白细胞计数≥16.74×109/L(OR=1.18, 95%CI:1.01~1.39)和间隙积气(OR=0.03, 95%CI:0.00~0.30)可作为提示需要手术的危险因素(P值均<0.05)。结论临床医师应在治疗过程中警惕这些危险因素, 对满足条件的患者及时采取手术治疗。

Objective To explore risk factors affecting treatment for deep neck space infections(DNSIs)so as to provide guidance for appropriate early managements.Methods A retrospective cohort study was conducted on inpatients with DNSIs admitted to the Department of Otolaryngology,Head and Neck Surgery,Affiliated Hospital of Qingdao University from March 2013 to February 2021.Patients were divided into surgical and non-surgical groups based on whether they had surgery or not.Information collected included demographic data,disease-related signs and symptoms,treatment history,systemic comorbidities,imaging data and laboratory indicators.Hypothesis testing,univariate Logistic regression and multivariate Logistic regression were used for data processing.Resuts A total of 61 patients were included,including 37 males and 24 females,aged 6-96 years.There were 35 cases(57.4%)in the surgical group and 26 cases(42.6%)in the non-surgical group.Multivariate analysis showed that risk factors for surgery as followings:neck dyskinesia(OR=0.03,95%CI:0.00-0.24),dysphagia(OR=0.10,95%CI:0.02-0.72),serum white blood cell count≥16.74×109/L(OR=1.18,95%CI:1.01-1.39)and interspace gas(OR=0.03,95%CI:0.00-0.30).Conclusion Clinicians should be alert to these risk factors for surgery in the course of treatment and timely surgical treatment for patients who meet the conditions.