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來源資料
頁籤選單縮合
題名 | 深頸部感染--83例回顧=Deep Neck Infections--A Retrospective Study of 83 Cases |
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作者 | 林肇穗; 蘇茂昌; 黃志堅; 劉乃文; 李清課; | 書刊名 | 中華民國耳鼻喉科醫學會雜誌 |
卷期 | 33:1 1998.02[民87.02] |
頁次 | 頁52-60 |
分類號 | 416.892 |
關鍵詞 | 深頸部感染; 切開引流; 氣管切開術; Deep neck infection; Incision and drainage; Tracheostomy; |
語文 | 中文(Chinese) |
中文摘要 | 背景:危及生命的深頸部感染,在治療上,尤其手術的時機,尚存有爭議。 本文 對深頸部感染的細菌培養結果、病因、症狀、診斷及適切的治療等加以探討。 方法:從 1990 年 8 月至 1996 年 7 月 6 年期間, 我們經歷 83 例符合深頸頭部感染的 住院病人,其中包括扁桃體周圍膿瘍 60 名, 側咽膿瘍 11 名,路威奇氏咽峽炎 3 名,頜 下膿瘍 4 名,腮腺膿瘍 4 名,咽後膿瘍 1 名。男性與女性比是 50:33,年齡從 11 歲至 80 歲,平均年齡 41.7 歲。 住院期間均給予抗生素治療,必要時給予切開引流及氣管切開 術。 結果: 在本系列中, 細菌培養結果以 Streptococcus 最多見, 其次是 Neisseria 及 Klebsiella pneumoniae 等;造成深頸部感染的病因中,除了不明原因外,最常見的是扁桃 體炎及咽炎,其次是齒源性因素;接受切開引流方面,齒源性患者( 8 名中有 7 名)及糖 尿病患者( 10 名中有 9 名)有較高的比率。 結論:深頸部感染的治療原則是正確的診斷、強力抗生素治療、呼吸道的維持及適時的切開 引流。 本系列中 penicillin 及 clindamycin 是主要的選擇用藥,而呼吸道的維持是以局 部麻醉實施氣管切開術為主。 而切開引流的時機則需以頸部 CT、病人對抗生素的反應、感 染的路徑及病人免疫狀況等為考量依據。 |
英文摘要 | Background: There are some debates on the treatments, especially on the operation timing, over the deep neck infections. This study makes further research on the pus culture result, etiology, symptoms, diagnosis, and proper treatments etc. Methods: From August of 1990 to July of 1996, we collect 83 in-patients meeting the criteria of deep neck infections, including 60 cases of peritonsillar abscess, 11 of parapharyngeal abscess, 3 of Ludwig's angina, 4 of submandibular abscess, 4 of parotid abscess and 1 of retropharyngeal abscess. The ratio of male to female is 50 to 33. The average age of those patients is 41.7y/o from the range from 11y/o to 80y/o. The intravenous antibiotics were administrated during admission. Incision and drainage as well as tracheostomy were performed on the necessary condition. Results: In our series, pus culture result reveals that the most common strain is Streptococcus, followed by Neisseria, Klebsiella pneumoniae etc. Besides unknown cause, the deep neck infections are commonly caused by tonsillitis and pharyngitis, then by odontogenic origin. Also in the surgical group, there was a higher percentage in the odontogenic origin (7 in 8) and DM patients (9 in 10). Conclusions: The therapeutic principle for deep neck infections is the accurate diagnosis, high dose antibiotics, maintenance of upper airway and performing incision and drainage in proper time. Penicillin and clindamycin are the drugs of choice. The maintenance of upper airway depends mainly on tracheostomy with local anesthesia. The timing for surgical interventions in according to the findings of neck CT, the effect of antibiotic treatment, the infection source and the patients' immune status etc. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。