下行性坏死性纵隔炎的临床诊治体会

发布时间：2018-01-18 10:37

  本文关键词：下行性坏死性纵隔炎的临床诊治体会　出处：《第四军医大学》2010年硕士论文　论文类型：学位论文

  更多相关文章： 下行性坏死性纵隔炎 电子计算机断层扫描 外科引流

【摘要】：目的: 探讨下行性坏死性纵隔炎患者的临床诊断和治疗,旨在为临床提高该病的早期诊断率和治愈率提供帮助。 方法: 回顾分析2006年-2009年间我院诊治的8例下行性坏死性纵隔炎患者的临床资料。 结果: 本组8例患者均依据患者的临床表现,颈、胸部CT扫描特征和细菌学培养结果确诊。其中牙源性感染6例,合并糖尿病6例。细菌培养混合感染者6例,厌氧菌4例。颈部切开引流术1例,开胸手术6例,胸腔镜手术1例。痊愈6例,死亡2例。 结论: 本组下行性坏死性纵隔炎多见于牙源性感染,其发展迅速,合并糖尿病者病死率高,根据患者病史、症状和体征,颈胸部CT检查和细菌培养是诊断的有效方法。早期、足量应用广谱抗生素;根据CT分型采取个体化的切开引流;同时有效处理糖尿病等合并症和支持治疗是降低死亡率的有效手段。
[Abstract]:Objective: To explore the clinical diagnosis and treatment of down-going necrotizing mediastinitis in order to improve the early diagnosis and cure rate of the disease. Methods: The clinical data of 8 patients with descending necrotizing mediastinitis from 2006 to 2009 in our hospital were retrospectively analyzed. Results: All the 8 patients were diagnosed according to the clinical manifestations, CT features of neck and chest and the results of bacteriological culture, including 6 cases of odontogenic infection, 6 cases of diabetes mellitus and 6 cases of mixed bacterial culture infection. Anaerobes in 4 cases, cervical incision and drainage in 1 case, thoracotomy in 6 cases, thoracoscopic surgery in 1 case, recovery in 6 cases and death in 2 cases. Conclusion: This series of descending necrotizing mediastinitis is more commonly seen in odontogenic infection, its development is rapid, the mortality of patients with diabetes is high, according to the patient's history, symptoms and signs. Ct examination of neck and chest and bacterial culture were effective methods for diagnosis. According to CT classification, individualized incision and drainage were adopted. Effective treatment of diabetes and other complications and supportive treatment is an effective way to reduce mortality.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

【参考文献】

中国期刊全文数据库 前8条

1 王永功,侯明,刘青青,崔广庆,王稼祥,钱浩宇;牙源性坏死性纵隔炎[J];华西口腔医学杂志;2001年05期

2 王永功;杨志刚;何苡;;头颈部感染并发下行坏死性纵隔炎的诊断和治疗[J];医药论坛杂志;2008年14期

3 李厚勇;吴t 雯;周梁;;颈侧小切口引流治疗糖尿病伴发咽后脓肿5例[J];临床耳鼻咽喉头颈外科杂志;2007年15期

4 上官诚芳;吴继昌;王士礼;蔡昌枰;周翔;陈中元;;严重颈深部感染引发下行性坏死性纵隔炎1例[J];临床耳鼻咽喉头颈外科杂志;2009年14期

5 史向阳,井松,赵文刚,白玉,王文旭,于克达,马亮;下行性坏死性纵隔炎的诊治及护理[J];中国实用护理杂志;2005年12期

6 张海明;;急性、坠入性、坏死性纵隔炎4例报道[J];中国现代医生;2008年15期

7 徐富仁，辛定一，蒋锡初，，常建华，曹子昂，金小寅;急性感染性纵隔炎的诊断和治疗（25例报告）[J];中华胸心血管外科杂志;1994年02期

8 刘晶春;刘钢;;下行坏死性纵隔炎合并右上肺感染1例分析[J];中国误诊学杂志;2008年12期

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