口咽部感染并发化脓性纵膈炎-附6例临床病例

目的报道口咽部感染并发化脓性纵膈炎（称为下行性坏死性纵膈炎descending necrotizing mediastinitis DNM）的病例资料，供临床作借鉴。方法报道6例口咽部感染并发化脓性纵膈炎病例的临床特点及治疗方法。结果本病的感染多为厌氧茵和需氧茵的混合感染；内脏后间隙是感染由口咽部向纵膈扩散的主要途径；治疗的关键是全身抗菌素应用＋颈纵膈引流。结论DNM是一种发展迅速的致死性炎性疾病。早期的诊断、有效的治疗、多学科协同配合抢救可以大大降低死亡率。

Oropharyngeal infection with suppurative mediastinitis complication

Objective To report clinical characteristics of suppurative mediastinitis as a complication of oropharyngeal infection (Descending Necrotizing Mediastinitis DNM).Methods The clinical manifestations and treatment of 6 cases with DNM were reported.Results DNM was most frequently seen as a mixed bacterial infection by both aerobes and anaerobes.The posterior visceral space was the principal route of spreading infection from the oropharynx into the mediastinum.Antiobiotic therapy and the cervicomediastinal drainage procedure were reliable treatment method.Conclusion DNM is a lethal and phlogistic disease that develops rapidly.It is possible to reduce death rate consumedly with early diagnosing,effectively treating and multi-subject cooperating.