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題名 | 齒源性感染引發下行壞死性縱膈腔炎--病例報告=Descending Necrotizing Mediastinitis of Odontogenic Infection--A Case Report |
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作者姓名(中文) | 王銀來; 邢憶春; 賴威伸; 趙培勳; 張再財; 高文斌; 許正義; 蘇煥鈞; | 書刊名 | 中華民國口腔顎面外科學會雜誌 |
卷期 | 15:1 2004.03[民93.03] |
頁次 | 頁18-26 |
分類號 | 416.226 |
關鍵詞 | 下行壞死性縱膈腔炎; 齒源性感染; Descending necrotizing mediastinitis; Odontogenic infection; |
語文 | 中文(Chinese) |
中文摘要 | 下行壞死性縱膈腔炎 (Descending Necrotizing Mediastinitis) 是一種由頭頸部感染向下蔓延所引發的罕見且經常致死的疾病。由於感染的部位包含許多重要血管及臟器,因此經常造成極嚴重之併發症。因疾病的初期經常被疏忽,故需早期診斷確立。可利用電腦斷層攝影檢查提供病兆之所在位置,作適時的引流、清創,並施予大量的抗生素治療以及足夠的營養和呼吸支持。如要成功的診治下行壞死性縱膈腔炎,則必須對頭頸部及胸部的解剖構造、致病機轉及細菌學、疾病的臨床症狀、及併發症處置等有深入的了解。本文報告一糖尿病患者因左下顎第一大臼齒殘根引起之齒源性感染導致下行壞死性縱膈腔炎,經頸部切開及開胸手術引流縱膈腔膿瘍,並多次清創後成功治療之病例。 |
英文摘要 | Descending necrotizing mediastinitis usually caused by infection originating from the head and neck. Though it is not ordinal while often causing death. Involving a lot of important organs and vessels, infection of descending necrotizing mediastinitis usually results in serious complications. It is important to make early and accurate diagnosis in the beginning of the disease. Utilizing the computer tomograph to localize the sources of the infection, prompt and correct debridement and drainage, supported with large amount of antibiotics and nutrition are the keys to successfully treat the patient. In order to treat the descending necrotizing mediastinitis, it is necessary to have profound understanding of the anatomic structures of the head, neck and chest, bacteriology, clinical symptoms and treatment of the complications. In this article, we reported a case of descending necrotizing mediastinitis of odontogenic infection resulting from residual root of left mandibular first molar. The patient successfully survived after repeated debridement and drainage by the combined surgery of oral surgeons and chest surgeons. |
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