【摘要】：目的:探討異物所致頸部膿腫的臨床特點(diǎn)、診斷以及治療方式,加深對(duì)異物所致頸部膿腫的認(rèn)識(shí),以提高對(duì)該病的診斷及治療水平,改善預(yù)后。方法:回顧性分析我科2012年-2015年所收治的3例異物所致頸部膿腫患者的臨床資料,并復(fù)習(xí)中英文類似報(bào)道病例資料46例,共49例。分析指標(biāo)包括病史、影像學(xué)的選擇,治療方式及手術(shù)方式的選擇、并發(fā)癥等。結(jié)果:49例患者異物史1天~半年不等;影像學(xué)檢查選擇CT 41例,X線5例,超聲2例。采用手術(shù)引流膿腫48例(98%),其中選擇頸側(cè)切開(kāi)者31例;術(shù)中發(fā)現(xiàn)并取出異物46例(93.9%);保守治療僅1例(2%);僅3例(6.1%)行了氣管切開(kāi);共17例(34.7%)有并發(fā)癥出現(xiàn),包括8例呼吸驟停,其中7例因麻醉插管中膿腫破裂膿液溢出所致,均為嬰幼兒,1例因膿腫巨大壓迫氣道所致,3例膿毒性休克,3例縱隔膿腫,2例聲帶麻痹,頸動(dòng)脈破裂1例,所有報(bào)道病例均治愈出院。結(jié)論:異物所致頸部膿腫病情危重,較普通頸部膿腫并發(fā)癥多。結(jié)合病史及影像學(xué)檢查,及早診斷發(fā)現(xiàn)并取出異物,盡早頸部膿腫引流是治療關(guān)鍵。
[Abstract]:Objective: to explore the clinical features, diagnosis and treatment of cervical abscess caused by foreign body, and to improve the diagnosis and treatment of the disease. Methods: the clinical data of 3 cases of cervical abscess caused by foreign bodies in our department from 2012 to 2015 were analyzed retrospectively, and 46 cases (49 cases) of similar cases in Chinese and English were reviewed. Analysis included history, choice of imaging, choice of treatment and operation, complications, etc. Results: the history of foreign body in 49 patients ranged from 1 day to 6 months. CT was performed in 41 cases, X-ray in 5 cases and ultrasound in 2 cases. Surgical drainage and abscess were performed in 48 cases (98%), among which 31 cases were selected for lateral cervical incision, 46 cases (93.9%) were found and removed during operation, only 1 case (2%) was treated conservatively, only 3 cases (6.1%) underwent tracheotomy. A total of 17 cases (34.7%) had complications, including 8 cases of respiratory arrest, of which 7 cases were caused by abscess rupture and pus overflow during anesthesia intubation, all of them were infants, 1 case was caused by abscess and huge compression of airway, 3 cases were septic shock. There were 3 cases of mediastinal abscess, 2 cases of vocal cord paralysis and 1 case of carotid artery rupture. All the reported cases were cured and discharged. Conclusion: cervical abscess caused by foreign body is more serious than common cervical abscess. Combined with history and imaging examination, early diagnosis and removal of foreign bodies and early drainage of cervical abscess are the key to treatment.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R653

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