急性会厌炎并会厌脓肿2例成功抢救经验

急性会厌炎是耳鼻咽喉科常见急危症之一,因发病急且进展迅速,如控制不力,随时可发生急性喉阻塞,造成窒息而危及生命。急性会厌炎如未及时控制可并发会厌脓肿,其病情更凶险,短时间可致患者呼吸道梗阻。近年来东莞市太平人民医院耳鼻咽喉头颈外科成功抢救2例急性会厌炎伴会厌脓肿患者,均取得较好的疗效,现报告如下。1病例报告例1,男,35岁。因＂咽痛伴吞咽疼痛5d,加重伴吞咽、呼吸困难1d＂为主诉急诊入院。     

急性会厌炎142例临床分析

目的 总结急性会厌炎的诊断和治疗经验。提高疗效。方法 回顾性分析我科1990年1月-2001年8月收治的142例急性会厌炎患者的临床资料，总结经验，提高疗效。结果 本组142例均有咽痛，126例伴吞咽困难，68例伴呼吸困难，会厌舌面粘膜均有不同程度的充血水肿，其中发生会厌脓肿12例，因喉梗阻而行气管切开4例。结论 咽喉疼痛是急性会厌炎的首发症状，喉镜检查是明确诊断的重要手段。抗感染和维持气道通畅是治疗关键，必要时应建立人工气道。     

白塞病误诊为急性会厌炎两例

正1资料与方法1.1病例1患者,男,35岁,因"声音嘶哑2个月"于2016年12月18日收入青岛大学附属医院耳鼻咽喉头颈外科(以下简称"我科")。其诉2个月前,因情绪波动出现声音嘶哑,晨起症状轻,午后加重,无发热,无咽痛,无吞咽及呼吸困难,症状逐渐加重,遂于当地医院住院治疗,诊断"急性咽喉炎、急性会厌炎",给予抗感染及激素治疗,声嘶缓解不明显,故转来我院求诊。     

急性会厌炎合并糖尿病的临床特点

目的探讨急性会厌炎合并糖尿病的临床特点。方法采用回顾性病例对照研究,比较急性会厌炎合并糖尿病40例和非糖尿病性急性会厌炎60例的临床表现及治疗反应。结果在发病起因、咽痛或（和）吞咽疼痛程度方面两组无显著差异,在治疗时间、病情缓解时间、发生呼吸困难方面两组有显著差异。结论急性会厌炎合并糖尿病以中老年人多见,易发生呼吸困难,治疗时间长,对治疗的反应较差。     

Clinical evaluation of intravenous ampicillin as empirical antimicrobial treatment of acute epiglottitis

Introduction: The significant pathogens in acute epiglottitis (AE) are poorly defined in the post Haemophilus influenza type b-vaccine era. Furthermore, there is a lack of clinical evaluations of antibiotic regimens in patients with AE. We aimed to evaluate the effectiveness of empiric intravenous ampicillin in the treatment of patients with AE.

Materials &; methods: All patients admitted with AE to the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark, from 2001 to 2015 were included.

Results: In total, 103 (51 males) patients were included in the study. The median duration of hospitalization was four days. There was no statistical significant difference between patients initially treated with intravenous ampicillin (n?=?83) or other antibiotics (n?=?20) (p?=?.26). The antibiotic regimen was altered during admission in 11% of patients, without significant difference between antibiotic groups (ampicillin 10% vs non-ampicillin 15%, p?=?.44). Complications potentially related to insufficient antibiotic treatment were observed in four (5%) patients initially treated with ampicillin, but in none of the patients initially treated with antibiotics other than ampicillin (p?=?1.00). Throat swab cultures and blood cultures frequently yielded negative results.

Conclusions: Intravenous ampicillin is efficient as empiric antibiotic therapy for AE patients, leading to a quick recovery and low complication rates.     

以急性会厌炎为首诊的3例颈部坏死性筋膜炎病例报告并文献复习

目的 探讨急性会厌炎与颈部坏死性筋膜炎的相关性及治疗经验.方法 回顾性分析3例以急性会厌炎为首诊的颈部坏死性筋膜炎患者的临床资料,对急性会厌炎与颈部坏死性筋膜炎间的相关性及诊治经过进行分析.结果 3例患者经颈部CT明确诊断后均行手术治疗,1例死亡,2例治愈出院.结论 对于以急性会厌炎为首诊经积极抗感染抗炎治疗无效的患者...     

Paediatric epiglottitis: the influence of the Haemophilus influenzae b vaccine,a ten-year review in the Sheffield region

Cases of acute epiglottitis in children have become very uncommon in recent years. This study set out to find whether the introduction of the Haemophilus influenzae b (Hib) vaccine in the UK in October 1992 has influenced the incidence of acute epiglottitis in the Sheffield region, and whether the pathogenesis has altered. A 10-year retrospective case note review was undertaken. A total of 30 children were treated for acute epiglottitis in Sheffield Children’s Hospital over that time period. A sharp decline in the number of cases was found after the vaccine was introduced. Most children presenting with the disease after October 1992 had not been vaccinated. In addition, the pathogens isolated in those children who had received the vaccine were all Streptococci. This is the first study in the UK to examine the influence of the Hib vaccine on acute paediatric epiglottitis.     

Orbital lymphatic malformation showing the symptoms of orbital complications of acute rhinosinusitis in children: A report of 2 cases

Orbital lymphatic malformations are benign cystic malformations of the lymphatic system. The present report shows two cases with symptoms of orbital complications of acute rhinosinusitis with proptosis, compressive optic neuropathy, loss of vision and cellulites in children. Magnetic resonance imaging (MRI) revealed a well-demarcated intraorbital mass with heterogeneous signal conformable with lymphatic malformation in both cases. A tumor extirpation was performed via lateral orbitotomy in both cases. Postoperatively the symptoms and especially the loss of vision improved completely. Histological analysis of the surgical specimens verified lymphatic malformations of the orbit. Orbital lymphatic malformations can mimic the symptoms of orbital complications of acute rhinosinusitis. The existence of lymphatic malformation should be considered in every orbital complication of rhinosinusitis in children.     

布地奈德治疗急性会厌炎

目的研究布地奈德治疗急性会厌炎的疗效。方法选择78例急性会厌炎患者,随机分成两组,分别给予雾化吸入布地奈德和地塞米松,其他治疗基本相同,统计治疗结果。结果布地奈德组有效率为98%(41/42),显效率为95%(40/42);地塞米松组有效率为81%(29/36),显效率为72%(26/36);两组间有效率差异具有显著性意义(P=0.03556),显效率差异具有极显著性意义(P=0.00498)。结论雾化吸入布地奈德治疗急性会厌炎起效快,局部抗炎作用强,能快速减轻会厌水肿,减少气管切开的几率。     

Isolated laryngeal lymphangioma showing the symptoms of acute epiglottitis

Lymphangiomas are rare, congenital lesions of the lymphatic system, and about 90% of them are detected by the 2nd year of life. Although the head and neck region is the most common place of presentation, isolated laryngeal lymphangioma is extremely rare. A 37-year-old female patient presented with characteristic symptoms of acute epiglottitis. After her acute symptoms resolved with medical treatment, endoscopy was performed, and a wide, pedunculated mass arising from the epiglottis of the larynx was seen. The mass was totally excised and microscopically diagnosed as lymphangioma. To our knowledge, this is the first such case reported in the literature. In the control examination performed after 9 months, no evidence of recurrence was revealed. This interesting case illustrates that the symptoms of acute epiglottitis in the adult should be further investigated to exclude rare lesions such as lymphangioma.     

Risk of acute otitis media in relation to acute bronchiolitis in children

Objective

A prospective study was carried out to evaluate the prevalence and the etiology of acute otitis media (AOM) in children with acute bronchiolitis. Also to determine whether AOM occurring with acute bronchiolitis is accompanied with another pathogens or not.

Subjects and methods

One hundred and eighty children with acute bronchiolitis aged 3-18 months who were admitted to pediatrics department, Minia University hospital, were included in the study done in the winter and spring of 2009. In patients with AOM at entry or developed AOM within 14 days, Gram-stained smears, bacterial cultures, and enzyme-linked immunosorbent assay (ELISA) were performed on middle-ear aspirates to detect the presence of bacterial pathogens and RSV respectively.

Results

One hundred children (55.6%) with acute bronchiolitis had AOM at entry or developed AOM within 14 days, 45 patients (25%) had developed otitis media with effusion, and only 35 patients (19.4%) remained free throughout the 2-week observation period. Of 135 middle-ear aspirates (65 unilateral and 35 bilateral), bacterial pathogens were isolated in 86 patients (86%) [37 bacteria alone “37%” and 49 mixed bacteria and RSV “49%”], RSV was identified in 56 patients (56%) of middle ear aspirates [mixed with bacteria in 49 patients and RSV alone in 7 cases (7%).

Conclusion

We concluded that bacterial AOM is a complication in most children with acute bronchiolitis. Streptococcus pneumonia and Haemophilus influenza were the commonest organisms isolated from middle ear aspirate. RSV is identified in 56% of acute otitis media with bronchiolitis.     

Scanning electron microscopic studies of the nasal blood vessels

Summary Current histological and transmission electron microscopic techniques are insufficient for studying all different aspects of vascular morphology. As a result, we have used scanning electron microscopy (SEM) to examine nasal blood vessels. In our present studies the nasal septa of 15 rabbits were fixed by vascular perfusion, dried by the critical point method and coated with gold for SEM studies. Lower magnifications of specimens using this method show the tissue arrangement in the nasal septum. In higher magnifications the different vessels can be distinguished by their morphological features. The course of the vascular structures can be obverved as well as the junctions between the different vessels. Our results indicate that different morphological techniques must be combined to understand the endonasal vasculature.     

急性共同性内斜视的临床特点、治疗方法及长期疗效

目的 探讨急性共同性内斜视(AACE)的临床特点、治疗方法并观察其长期疗效。 方法 2014年10月至2017年6月山东大学附属省立医院东院区眼科收治的AACE患者11例,根据其不同的临床特点,分别采取配戴三棱镜或手术的治疗方法,对其治疗后复视、眼位、眼球运动及双眼视功能的长期疗效进行观察。 结果 观察6个月以上,配戴三棱镜患者戴镜后复视消失,双眼视功能恢复正常;手术患者术后复视消失,眼位正位,眼球运动未出现非共同性,双眼视功能提高。 结论 急性共同性内斜视根据其临床特点、斜视度大小、复视程度,采取不同的治疗方法,配戴三棱镜及手术治疗均取得了比较满意的长期效果。     

Scanning electron microscopy of the nasal glands and vessels

Summary The trypsin-HCl method of Uehara was applied to the respiratory nasal mucosa of rats and guinea pigs, and the stereoscopic surface view of the nasal glands, vessels, and associated nerve fibers were observed under the scanning electron microscope (SEM).The terminal portion of the glands was composed of glandular cells and myoepithelial cells, the latter were starfishlike features and extended thin cytoplasmic processes which covered the small area of the terminal portion. The arterioles and venules could be clearly distinguished by their adventitial aspects and innervation pattern. Arterioles were occasionally connected to small arterioles with a characteristic structure, which seemed to play a role in the regulation of peripheral blood supply.