口腔颌面部多间隙合并颈部及胸腔纵隔感染的回顾性分析

目的探讨口腔颌面部多间隙感染合并颈部及胸腔纵隔感染的诊断、治疗及预后。方法回顾性分析5例口腔颌面部多间隙感染合并颈部及胸腔纵隔感染患者的临床资料,分析其感染来源、临床特点、并发症及处理。结果 5例患者均为牙源性感染,临床表现为颌下、口底、颈部广泛肿胀,脓液形成。影像学显示2例纵隔及胸腔内有脓液形成。经过及时广泛切开引流及多学科综合治疗,4例痊愈,1例死亡。结论对于临床上颌面多间隙感染合并颈部广泛肿胀的病例应予高度重视,影像学检查在早期诊断中有很高价值,应尽早行多部位的切开引流及多学科综合治疗。

Treatment of maxillofacial multiple space infections with spread of cervical region and mediastinum

Objective To explore the clinical characteristics,diagnosis and treatment of maxillofacial multiple space infections with spread of cervical region and mediastinum.Methods Five patients were identified form June 2001 to June 2011,we retrospective studied the etiology,diagnosis,complications and treatment.Results All patients had infected due to odontogenic source.Diffuse swelling,hyperemia and abscess formation in bilateral submandibular,mouth floor and cervical region.Radiography showed 2 cases had abscess in the mediastinum and chest.After multi-discipline approaching,extensive drainage and cooperative management,four patients recovered,unfortunately,one patient died.Conclusion The patients with diffuse swelling in submandibular area,mouth floor and spread of cervical region must be carefully treated.Early extensive drainage and multi-discipline approaching are very important.Chest-ray and CT are crucial in early diagnosis.