目的 近年来颈深部间隙感染的发生率有增加的趋势,有时治疗十分棘手,本文的目的就是通过复杂病例的分析以提高临床医生对本病的再认识和治疗选择。方法 回顾分析2018年1月至2022年6月我院24例颈深部间隙感染患者的临床资料。结果 24例患者中男女比为1.67:1,大于50岁17例(70.83%)。所有患者抗生素治疗,12例接受了手术治疗,其中6例(25.0%)颈侧切开包括2例(8.3%)颈胸联合切开引流,5例(20.8%)口内切开引流, 1例(4.2%)经皮纵隔穿刺引流,气管切开1例(4.2%)。7例属于严重和复杂感染,累及3个或以上间隙,伴糖尿病4例,颈部坏死性筋膜炎3例,纵膈脓肿3例、败血症2例。结论 复杂颈深部间隙感染多见于老年男性和糖尿病患者,早期诊断和及时治疗是减少严重并发症的关键,针对不同部位的感染,采用个体化治疗有助于缩短病程。
Objective The incidence of deep neck infection (DNI) has been increasing in recent years. Sometimes, the treatment of DNI is intractable. This study aims to improve the clinician"s understanding of this disease and the choice of treatment through the analysis of difficult cases with DNI. Methods Clinical data of 24 patients with deep cervical space infection in our hospital from January 2018 to June 2022 were analyzed retrospectively. Results The male-to-female ratio of 24 patients was 1.67:1, and 17 patients (70.83%) were over 50 years. All patients were treated with antibiotics. 12 patients received surgical treatment, including 6 cases (25.0%) underwent lateral cervical incision and drainage, 2 (8.3%) underwent combining cervicothoracic incision drainage, 5 (20.8%) underwent intraoral incision drainage, 1 (4.2%) underwent percutaneous mediastinal puncture drainage and 1 (4.2%) underwent tracheotomy. There were 7 patients were severe and complex infection involving 3 or more spaces,4 with diabetes, 3 with necrotizing neck fasciitis, 3 with mediastinum abscess and 2 with septicemia. Conclusions Complicated deep neck space infection tends to occur in elderly men and patients with diabetes. Diagnosed early and treated promptly play a critical role in reducing serious complications. Individualized treatment strategies can help shorten the course of infection in different space.