颌面部颈部筋膜间隙感染的CT诊断

发布时间：2018-09-05 15:20

【摘要】：目的探讨颌面部颈部筋膜间隙医院感染及多层螺旋CT诊断意义,为临床诊断治疗提供参考。方法选择2009年7月-2014年3月在医院接受诊治的52例颌面部颈部筋膜感染患者,其行手术后采集引流脓汁进行细菌培养,同时进行厌氧菌培养;观察多层螺旋CT诊断表现及蔓延途径,应用软件SPSS19.0进行数据处理分析。结果 52例感染患者标本中培养出病原菌59株,前3位病原菌依次为肺炎克雷伯菌13株、酿脓链球菌16株、咽峡炎链球菌8株,分别占22.03%、27.11%、13.56%;多层螺旋CT诊断52例患者感染呈蜂窝织炎或脓肿,脓肿CT表现为脓肿壁环形强化,脓腔呈低密度;蜂窝组织炎CT表现为受累肌肉增厚肿大,边界模糊;受累部位的皮肤水肿增厚,筋膜间隙内脂肪消失;52例患者筋膜间隙感染包括咀嚼肌间隙感染27例、口底间隙感染12例、颈动脉间隙脓肿感染10例、扁桃体周围间隙感染3例。结论颌面部颈部筋膜间隙感染应用多层螺旋CT诊断准确性高,且该诊断显示蔓延途径,具有重要临床价值。
[Abstract]:Objective to investigate the significance of nosocomial infection and multilayer spiral CT in diagnosis of maxillofacial cervical fascial space infection and to provide reference for clinical diagnosis and treatment. Methods from July 2009 to March 2014, 52 patients with maxillofacial cervical fascia infection were selected. The diagnosis and spread of multilayer spiral CT were observed and the data were analyzed by software SPSS19.0. Results 59 strains of pathogenic bacteria were cultured in 52 infected patients, 13 strains of Klebsiella pneumoniae, 16 strains of Streptococcus pyogenes and 8 strains of Streptococcus isthmus were first 3 pathogens. Multilayer spiral CT was used to diagnose 52 patients with cellulitis or abscess, abscess CT showed circular enhancement of abscess wall and low density of abscess cavity, and CT of cellulitis showed thickening of affected muscles and blurred boundary. Skin edema and thickening were found in the affected site. In 52 cases, the infection of fascia space included masticatory space infection in 27 cases, floor of mouth space infection in 12 cases, carotid space abscess infection in 10 cases, and peritonsillar space infection in 3 cases. Conclusion the diagnosis of maxillofacial cervical fascial space infection by multilayer spiral CT is accurate, and the diagnosis shows the way of spread, which has important clinical value.
【作者单位】：无锡市精神卫生中心影像科;
【基金】：江苏省卫生厅基金资助项目(JW-2010B030)
【分类号】：R782.3

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