颈深部脓肿50例临床分析

目的探讨颈深部脓肿患者的临床表现、微生物学、影像学及治疗经验。方法对1997年1月—2002年12月收治的50例颈深部脓肿患者的临床资料进行了回顾性分析。结果颈深部脓肿的感染来源有：牙源性3例，急性化脓性扁桃体炎及喉炎8例，上呼吸道感染9例，咽喉及食道异物14例，糖尿病伴感染5例，不明原因11例。50例中21例作了脓液细菌培养，其中13例(64％)为阳性。通过采用脓肿切开引流术，经颈一纵隔引流术，大剂量抗生素等综合治疗，50例中治愈46例(92％)，死亡4例(8％)。死亡原因：2例为咽旁脓肿致颈部大血管破裂出血死亡，1例食道周围脓肿伴消化道大出血死亡，1例咽旁脓肿合并糖尿病中毒性休克死亡。结论颈深部脓肿一经确诊，应及时引流，合理应用抗生素，有效控制其他伴发病。重视对严重并发症的认识及处理，以提高治愈率。

Deep neck abscess: analysis of 50 cases

Objective To identify the predisposing factors of deep neck abscess and review diagnosis and treatment experience Methods A respective review was conducted in 50 cases who were diagnosed as having deep neck abscess in this hospital from Jan 1997 to Dec 2002 Results The causes of deep neck abscess were tooth diseases(3 cases), acute tonsillitis and laryngitis (8 cases), infection of upper respiratory tract (9 cases), foreign bodies in esophagus (14 cases), diabetes mellitus (5 cases), uncertain cause (11 cases) Among 21 cases of pus bacterial cultivation, 13(64%) cases were positive. By different ways of drainage including neck mediastinum incision, and use of large dosage of antibiotics, 46 six cases were cured and 4 cases died Two died of massive hemorrhage of neck blood vessel burst, one massive hemorrhage of upper digestive tract, another infective shock Conclusions Once deep neck abscess is diagnosed,early surgical drainage, appropriate use of antibiotics and control of complications and accompanying diseases are very important to improve the cure rate