口腔医学研究

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (11): 1223-1225.DOI: 10.13701/j.cnki.kqyxyj.2017.11.022

• 其他研究 • 上一篇    下一篇

颈坏死性筋膜炎伴下行纵隔炎的临床特点与手术治疗

杨旭1, 徐天舒1*, 郑亮2   

  1. 1. 常州市第一人民医院口腔颌面外科 江苏 常州 213000;
    2. 常州市第一人民医院胸外科 江苏 常州 213000
  • 收稿日期:2017-05-04 出版日期:2017-11-20 发布日期:2017-11-29
  • 通讯作者: 徐天舒,E-mail:xtsyx1019@126.com
  • 作者简介:杨旭(1983~ ),男,江苏常州人,硕士,主治医师,主要研究方向为口腔颌面外科。

Clinical Characteristics and Surgical Treatment of Cervical Necrotizing Fasciitis Associated with Descending Necrotizing Mediastinitis

YANG Xu1, XU Tian-shu1*, ZHENG Liang2   

  1. 1.Department of Oral and Maxillofacial Surgery; The First Hospital of Changzhou, Changzhou 213000, China;
    2. Department of Thoracic Surgery. The First Hospital of Changzhou, Changzhou 213000, China
  • Received:2017-05-04 Online:2017-11-20 Published:2017-11-29

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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。

关键词: 坏死性筋膜炎, 纵隔炎, 手术治疗

Abstract: Objective: To retrospectively review 5 cases of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis (CNF/DNF), and to investigate the clinical characteristics and surgical treatment of this complex infection. Methods: Five patients, who underwent extensive cervical drainage, were identified from December 2012 to December 2016. Besides, two of them underwent the two-stage mediastinoscope drainage of mediastinum. Results: One patient was successfully treated after extensive cervical drainage, while other two patients who did not get efficient drainage of mediastinum were died of multiorgan failure related to septic shock. The rest patients who had undergone the two-stage mediastinoscope drainage of mediastinum were successfully treated. The mortality rate was 40%. Conclusion: High mortality is found in this complex infection. As it progresses quickly, prompt diagnosis and surgical treatment are essential for reducing mortality in CNF/DNM. Extensive cervical drainage and transthoracic drainage should be performed simultaneously without delay. Cervical drainage and mediastinoscope drainage is worthy of promotion.

Key words: Necrotizing fasciitis, Mediastinitis, Surgical treatment

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