深頸部感染引起胸部併發症－四例報告

Thoracic Complications of Deep Neck Infection - Report of Four Cases

陳穆寬(Mu-Kuan Chen) ； 溫永頌(Yung-Sung Wen) ； 蕭信昌(Hsin-Chang Hsiao) ； 張正權(Jeng-Chyuan Jang) ； 林同森(Torng-Sen Lin)

《中華民國耳鼻喉科醫學會雜誌》 32卷4期 (1997/08) Pp. 454-458

https://doi.org/10.6286/1997.32.4.454

摘要

本院於近1年內共成功處理4例深頸部感染引起胸部併發症，性別為3男1女，年齡分佈為3歲至62歲。病人主訴多為吞嚥疼痛與頸部紅腫。感染源方面，齒源性造成Ludwig’s angina有2例，梨狀窩外傷併頸段食道穿孔和上呼吸道感染各1例。併發症方面，急性化膿性縱膈腔炎4例，膿胸3例。3例於住院一天內緊急與胸腔外科醫師施行頸部切開探查引流及利用胸腔鏡與縱膈腔鏡引流積膿;另1例於住院第三天施行頸部探查引流及經頸部縱膈腔膿液引流。細菌培養多呈混合性菌落。4例經本人之細心照顧，均康復出院，平均住院14天。(中耳醫誌 1997;32:454-458)

關鍵字

深頸部感染 ； 併發症

並列摘要

Four cases of life threatening deep neck infection with thoracic complications were presented. Mediastinits were observed in 4 cases and purulent pleural effusion in 3 cases. The original infections were odontogenic Ludwig’s angina (2 cases); traumatic pyriform sinus with cervical esophageal perforation (1 case) and infection of upper respiratory tract (1 case). All four patients have recovered uneventfully. The history, decending routes, microbiology and management of this disease were discussed. Early recognition, immediate surgical drainage, empirical antibiotic treatment, airway management and adequate correction of exacerbating general condition are recommended.

並列關鍵字

deep neck infection ； complication