口底重症多间隙感染41例患者诊治的回顾性分析

发布时间：2019-03-06 11:47

【摘要】：目的:回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法:对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用(种类及疗程)、手术干预及转归等方面进行总结及系统性分析。结果:男女比例为2.4∶1,年龄10~93岁(平均46.23岁),农村城市比例为3∶1。14.6%患者初步诊断不准确。31%患者在发病后5 d内就诊。82.9%患者为牙源性感染,35%患者初诊时炎症已扩散至咽旁间隙、翼下颌间隙或者合并颈部感染,7.5%患者感染扩散至纵膈;2例患者入院后已合并严重纵膈及肺部感染,转呼吸内科治疗,1例因肾衰转泌尿外科治疗;38例患者入院后及时给予静脉滴注抗生素抗感染治疗、尽早完成切开引流,痊愈出院,平均住院21 d。结论:牙源性感染的重症口底多间隙感染最多见,其治疗的关键在于早期诊断,维持呼吸道通畅,选择合适的抗生素,尽早切开引流、综合治疗去除病因。
[Abstract]:Objective: to retrospectively analyze the clinical data of 41 patients with severe multi-space infection of floor of mouth. Methods: sex, age, epidemiological characteristics, inducement of infection, symptoms, preliminary diagnosis, important concomitant diseases, complications, clinical diagnosis, antibiotic use (type and course of treatment), The surgical intervention and outcome were summarized and analyzed systematically. Results: the ratio of male to female was 2.4 to 1, and the age was 10 to 93 years (average 46.23 years). In rural and urban areas, the initial diagnosis was not accurate in 3% of the patients, 31% in 5 days after onset, 82.9% of the patients were odontogenic infections, and 35% of the patients had spread to the parapharyngeal space at the time of initial diagnosis. 7.5% of the patients with pterygomandibular space or neck infection spread to the mediastinum. Two patients were complicated with severe mediastinal and pulmonary infection after admission, and one case was converted to urological treatment due to renal failure. 38 patients were treated with antibiotics in time after admission, incision and drainage were completed as soon as possible and recovered from hospital. The average hospitalization was 21 d. Conclusion: the most common severe multiple floor infection of odontogenic infection is the early diagnosis, maintenance of airway patency, selection of appropriate antibiotics, incision and drainage as soon as possible, and comprehensive treatment to remove the etiological factors.
【作者单位】：第四军医大学口腔医学院口腔颌面外科;空军总医院感染管理科;
【分类号】：R782.3

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