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題名 | 齒源性頭頸部感染--40例分析=Odontogenic Head and Neck Infection--A 40-Cases Analysis |
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作者 | 李啟鐘; 林泰良; 戴中杰; | 書刊名 | 中華民國耳鼻喉科醫學會雜誌 |
卷期 | 33:5 1998.10[民87.10] |
頁次 | 頁80-85 |
分類號 | 416.8 |
關鍵詞 | 齒源性感染; Odontogenic infection; |
語文 | 中文(Chinese) |
中文摘要 | 背景:由於國人的齲齒罹患率很高,齒源性頭頸部感染的病例屢見不鮮, 因此集相關病例作分析, 以為日後診治之參考。 方法: 收集民國 81 年 1 月至 86 年 12 月,新光醫院及省立醫耳鼻喉科所經歷之齒源性頭頸部感染病人 40 例。歸類如下:頭頸部 間隙膿瘍 29 例 (72.5%) ; 上頜竇炎 5 例 (12.5%);頭頸部蜂窩組織炎 5 例 (12.5%); 鼻中隔膿瘍 1 例 (2.5%)。依其年齡、性別、病變牙齒、潛在疾患、細菌學檢查及併發症加 以分析。 結果:男性居多數 (23/4,60%),平均年齡男性 47.7 歲,女性 45.6 歲。牙齒病 變以下排第 1 前臼齒及下排第 2 臼齒最常見 (10/40, 25%) 。 膿瘍以頜下間隙最多 (21/29, 72.4%) 。 潛在疾患以糖尿病 (12/40, 30%) 最常見, 鼻咽癌經放射治療患者 (7/40,17.5%) 次之。 草綠色鏈球菌是最常見的革蘭氏陽性菌;克雷白氏肺炎桿菌,則好發 於糖尿病人。結論:建立通暢之上呼吸道,給予適當之抗生素並及早手術引流,以避免嚴重 之併發症,是治療的主要方式。病情穩定後,照會牙科處理患部,以避免再發。 |
英文摘要 | Background: Odontogenic head and neck ] infection is inceased by the high incidence of caries in our conntry. We collected and analysed data of 40 cases in order to find the principles of management. Methods: Data of odontogenic head and neck infection experienced by Department of Otolaryngology of Provincial Tao-Yuan General Hospital and Shin Kong Wu Ho-Su Memoria Hospital were collected from January 1992 to December 1997. The patients were categorized as head and neck abscess (72.5%), maxillary sinusitis (12.5%), head and neck cellulitis (12.5%), and nasal septal abscess (2.5%). The clinical data including the patients' age, sex, pathologic teeth, underlying diseases, bacteriology and complications were analysed and discussed. Results: It reveals that the male were predominant. The lower first premolar and second molar teeth were the most common pathologic teeth. Diabetes mellitus was the main underlying disease. Streptococcus ivridans was the most common G(+) pathogen and Klebsiella pneumoniae was often found in patients with diabetes mellitus. Conclusions: The principles of the management are establishing a patent airway, surgical drainage of abscess as soon as possible for prevention of fatal complications and consulting dentist for treating the pathologic teeth for prevention of recurrence. |
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