|
|
- 2017
颈坏死性筋膜炎伴下行纵隔炎的临床特点与手术治疗
|
Abstract:
摘要 目的:探讨颈坏死性筋膜炎伴下行性纵隔炎患者的临床特点及手术方法,提高其早期诊断率及治愈率。方法:2012年12月~2016年12月我院共收治5例颈坏死性筋膜炎伴下行性纵隔炎患者,5例患者均接受颈部广泛切开引流,其中2例患者择期联合纵隔镜行纵隔引流。结果:1例患者行颈部广泛切开引流后治愈;2例患者择期联合纵隔镜引流后治愈;2例患者感染并发败血症导致多器官功能衰竭而死亡。结论:颈坏死性筋膜炎伴下行性纵隔炎进展快,死亡率高,早期诊断及颈、胸共同引流是治疗的关键,联合纵隔镜及时行颈、胸引流值得推广
| [1] | Karkas A,Chahine K, Schmerber S,et al. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis [J]. The British Journal of Surgery, 2010, 97(4)∶609-615 |
| [2] | Waheeb S,Salim M,Yosef M,et al. Streptococcal necrotizing fasciitis with toxic shock syndrome following cervical adenitis [J]. Int J Pediatr Otorhinolaryngol,2004,68(9)∶1209-1213 |
| [3] | Sakamoto H, Aoki T, Kise Y, et al. Descending necrotizing mediastinitis due to odontogenic infections [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000, 89(4)∶412-419 |
| [4] | Shimizu K, Otani Y, Nakano T, et al. Successful video-assisted mediastinoscopic drainage of descending necrotizing mediastinitis [J]. Ann Thorac Surg, 2006, 81(6)∶2279-2281 |
| [5] | Endo S,Murayama F,Hasegawa T,et al. Guideline of surgical management based on diffusion of descending necrotizing mediastinitis [J]. Jpn J Thorac Cardiovasc Surg,1999,47(1)∶14-19 |
| [6] | Chen KC, Chen JS, Kuo SW, et al. Descending necrotizing mediastinitis:a 10-year Surgical experience in a single institution [J]. Thorac Cardiovasc Surg,2008,136(1)∶191-198 |
| [7] | Kocher GJ,Hoksch B,Caversaccio M. Diffuse descending necrotizing mediastinitis:surgical therapy and outcome in a single-centre series [J]. Eur J Cardiothorac Surg,2012,42(4)∶66-72 |
| [8] | Estrera AS,Landay MJ,Grishma JM,et al. Descending necrotizing mediastinitis [J]. Surg Gynecol Obstet,1983,157(6)∶545-552 |
| [9] | Isowa N, Yamada T, Kijima T, et al. Successful thoracoscopic debridement of descending necrotizing mediastinitis [J]. Ann Thorac Surg, 2004, 77(5)∶1834-1837 |
| [10] | Hudorovic N, Vucetic B. Infrequent life-threatening complication of descending necrotizing mediastinitis;vertebral artery,internaljugular and subclavian vein rupture [J]. Int J Surg, 2008, 6(6)∶e48-e51 |
| [11] | Bou-Assaly W, McKellop J, Mukherji S. Computed tomography imaging of acute neck inflammatory processes [J]. World J Radiol,2010,2(3)∶91-96 |
| [12] | Chen IC, Hsu JH, Dai ZK. Management of descending necrotizing mediastinitis complicated with empyema by video-assisted thoracoscopic Surgery [J]. Pediatr Pulmonol, 2016, 51(5)∶e17-e20 |
