颈深部感染患者临床特征及高危并发症的影响因素分析

doi:10.3760/cma.j.cn441417-20241030-06013

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (6): 945-949.DOI: 10.3760/cma.j.cn441417-20241030-06013

颈深部感染患者临床特征及高危并发症的影响因素分析

高文浩¹ 赵蕊¹ 李桂林²

¹西安大兴医院耳鼻咽喉头颈外科，西安 710000；²南昌大学基础医学院生理学教研室，南昌 330006

收稿日期:2024-10-30 出版日期:2025-03-15 发布日期:2025-03-17
通讯作者: 赵蕊，Email：13891716581@163.com
基金资助:
国家自然科学基金（81560219）

Clinical characteristics and risk factors of high-risk complications in patients with deep neck infections

Gao Wenhao¹, Zhao Rui¹, Li Guilin²

¹Department of Otolaryngology, Head, and Neck Surgery, Xi'an Daxing Hospital, Xi'an 710000, China; ²Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, China

Received:2024-10-30 Online:2025-03-15 Published:2025-03-17
Contact: Zhao Rui, Email: 13891716581@163.com
Supported by:
National Natural Science Foundation (81560219)

摘要/Abstract

摘要：

目的　分析颈深部感染患者临床特征及高危并发症的影响因素。方法　本研究采用回顾性分析，选取2019年1月至2023年12月在西安大兴医院治疗的179例颈深部感染患者，其中男93例，女86例，年龄（55.04±12.74）岁。根据是否合并高危并发症分为高危组和非高危组，收集患者基本信息、临床表现、治疗方法及并发症。使用描述性统计分析临床特征，logistic回归分析并发症的危险因素，组间比较采用t、χ²检验。结果　179例患者中，发生高危并发症63例（35.20%）。高危组患者高热消退、脓腔闭合、疼痛缓解及住院时间均长于非高危组。高危组患者年龄较大，糖尿病发病率及合并咽喉炎症、颌面颈部淋巴结炎症、牙周/牙髓疾病的比例和糖皮质激素或抗生素的历史使用率、空腹血糖、白细胞计数及中性粒细胞百分比均高于非高危组，差异均有统计学意义（均P0.05）。多因素分析结果表明，年龄增加、糖尿病、牙周或牙髓疾病、历史糖皮质激素或抗生素使用、高白细胞计数及高中性粒细胞百分比是导致高危并发症风险显著增加的危险因素（均P0.05）。结论　颈深部感染患者中高危并发症的发生与年龄增加、糖尿病、牙周或牙髓疾病、历史糖皮质激素或抗生素使用、高白细胞计数及高中性粒细胞百分比有关。

关键词:

颈深部感染, 临床特征, 高危并发症, 影响因素

Abstract:

Objective　To analyze the clinical characteristics and high-risk complications of patients with deep neck infections. Methods　This was a retrospective study. One hundred and seventy-nine patients with deep neck infections treated at Xi'an Daxing Hospital from January 2019 to December 2023 were selected, including 93 males and 86 females who were (55.04±12.74) years old. They were divided into a high-risk group and a non-high-risk group according to whether they had high-risk complications. Their basic information, clinical manifestations, treatment methods, and treatment complications were collected. Descriptive statistics were used to analyze their clinical characteristics, and the logistic regression was used to analyze the risk factors for complications. The data were compared between the two groups by t and χ² tests. Results　Among the 179 patients, 63 (35.20%) had high-risk complications. The times for fever resolution, abscess closure, and pain relief and hospital stay in the high-risk group were longer than those in the non-high-risk group; the high-risk group were older than the non-high-risk group; more patients had diabetes, pharyngitis, cervicofacial lymphadenitis, and periodontal or pulp diseases and had used steroids or antibiotics in the high risk group than in the non-high-risk group; the fasting blood glucose, white blood cell count, and neutrophil percentage in the high-risk group were higher than those in the non-high-risk group; there were statistical differences (all P0.05). The multivariate analysis indicated that age, diabetes, periodontal or pulp diseases, historical use of steroids or antibiotics, high white blood cell count, and high neutrophil percentages were key factors significantly increasing the risk of high-risk complications (all P0.05). Conclusion　The occurrence of high-risk complications in patients with deep neck infections is associated with age, diabetes, periodontal or pulp diseases, historical use of steroids or antibiotics, high white blood cell count, and high neutrophil percentage.

Key words:

Deep neck infections, Clinical features, High-risk complications, Influencing factor

高文浩赵蕊李桂林.

颈深部感染患者临床特征及高危并发症的影响因素分析 [J]. 国际医药卫生导报, 2025, 31(6): 945-949.

Gao Wenhao, Zhao Rui, Li Guilin.

Clinical characteristics and risk factors of high-risk complications in patients with deep neck infections [J]. International Medicine and Health Guidance News, 2025, 31(6): 945-949.

参考文献

[1] Krarup JF, Nielsen HL, Danstrup CS. Severe deep neck space infection caused by Eggerthia catenaformis[J]. BMJ Case Rep, 2021,14(4):e241384. DOI: 10.1136/bcr-2020-241384.
[2] Ho CY, Chin SC, Wang YC, et al. Factors affecting patients with concurrent deep neck infection and aspiration pneumonia[J]. Am J Otolaryngol, 2022,43(3):103463. DOI: 10.1016/j.amjoto.2022.103463.
[3] Raghani MJ, Raghani N. Bilateral deep neck space infection in pediatric patients: review of literature and report of a case[J]. J Indian Soc Pedod Prev Dent, 2015,33(1):61-65. DOI: 10.4103/0970-4388.149009.
[4] 王艳,陈秀梅,张华,等. 颈深部感染61例临床治疗经验分析[J]. 中华耳鼻咽喉头颈外科杂志,2020,55(4):358-362.DOI:10.3760/cma.j.cn115330-20190911-00574.
[5] 庞燕,李培杰. 颈部卟啉单胞菌感染致高胆红素血症1例[J]. 中国急救医学,2021,41(6):502-505. DOI:10.3969/j.issn.1002-1949.2021.06.010.
[6] 李云鹏,石冰,张浚睿,等. 口腔颌面部间隙感染诊疗专家共识[J]. 中华口腔医学杂志,2021,56(2):136-144. DOI:10.3760/cma.j.cn112144-20200323-00169.
[7] Neville BW.口腔颌面病理学[M].北京:人民卫生出版社,2013:46-47,51.
[8] Saito Y, Asami M, Miki A, et al. Deep neck infection complicated by phlegmonous esophagitis and mediastinitis[J]. Ann Thorac Surg, 2021,111(6):e403-e406. DOI: 10.1016/j.athoracsur.2020.08.101.
[9] Devakumar H, Tailor B, Law S, et al. Deep neck space infection extending to the mediastinum that was treated conservatively[J]. BMJ Case Rep, 2022 ,15(9):e250881. DOI: 10.1136/bcr-2022-250881.
[10] Hidaka H, Yamaguchi T, Hasegawa J, et al. Clinical and bacteriological influence of diabetes mellitus on deep neck infection: systematic review and meta-analysis[J]. Head Neck, 2015,37(10):1536-1546. DOI: 10.1002/hed.23776.
[11] Wang B, Gao BL, Xu GP, et al. Images of deep neck space infection and the clinical significance[J]. Acta Radiol, 2014,55(8):945-951. DOI: 10.1177/0284185113509093.
[12] 王天宇,彭浒,谢影琦,等. 颈深部重度化脓性炎症并发脓毒症的临床诊疗与战现场诊治方式的探讨[J]. 中华航海医学与高气压医学杂志,2023,30(5):629-634.
[13] 范萌,尹训涛,刘光明,等. 儿童脓肿型与非脓肿型颈部感染性肿块的临床及影像特征分析[J/OL]. 新发传染病电子杂志,2024,9(2):1-6 [2024-09-10]. https://d.wanfangdata.com.cn/periodical/xfcrbdzzz202402002. DOI:10.19871/j.cnki.xfcrbzz.2024.02.001.
[14] 吴亚东,赵科,尹鑫海,等. 口腔颌面颈部感染致坏死性纵膈炎5例[J]. 贵阳医学院学报,2013,38(5):562,564. DOI:10.3969/j.issn.1000-2707.2013.05.041.
[15] 龙静,黄谢山,潘小萌,等. 负压封闭引流在颌面外科术后严重颌面颈部感染的应用[J/OL]. 中华口腔医学研究杂志(电子版),2018,12(5):294-298 [2024-09-10]. https://d.wanfangdata.com.cn/periodical/zhkqyxyjzz201805005.DOI:10.3877/cma.j.issn.1674-1366.2018.05.005.
[16] 冯珂,杨立山,王生发. 重症口腔颌面颈部感染合并呼吸道梗阻13例急诊救治体会[J]. 宁夏医学杂志,2015,37(10):947-948. DOI:10.13621/j.1001-5949.2015.10.0947.
[17] 丛麒峰,付洪海,王芳,等. 影响牙源性口腔颌面颈部多间隙感染治疗效果的危险因素[J]. 滨州医学院学报,2024,47(3):196-200,205. DOI:10.19739/j.cnki.issn1001-9510. 2024.03.007.
[18] 刘晖,邵贝贝,冯翠萍. 颌面颈部感染致坏死性纵隔炎的病原学分析与治疗[J]. 中华医院感染学杂志,2015,25(5):1156-1158. DOI:10.11816/cn.ni.2015-140585.
[19] Caprioli S, Tagliafico A, Fiannacca M, et al. Imaging assessment of deep neck spaces infections: an anatomical approach[J]. Radiol Med, 2023,128(1):81-92. DOI: 10.1007/s11547-022-01572-8.
[20] 齐东元,张锐,赵元龙,等. 负压封闭引流技术在治疗严重颌面颈部感染中的应用[J]. 实用口腔医学杂志,2017,33(6):824-826. DOI:10.3969/j.issn.1001-3733.2017.06.024.
[21] 聂燕丽,彭小忠,蔡毅,等. 颈部脊髓损伤术后感染预后因素的初步分析[J]. 中国微创外科杂志,2023,23(9):641-647. DOI:10.3969/j.issn.1009-6604.2023.09.001.
[22] 赵冉冉,李晨曦,热孜万古丽·亚森,等. 负压封闭引流在颌面颈部间隙感染致下行性坏死性纵隔炎治疗中的应用效果评价[J]. 中国口腔颌面外科杂志,2024,22(2):153-157. DOI:10.19438/j.cjoms.2024.02.007.
[23] 蒋威,金鑫. 颌面颈部多间隙感染危险因素及不同方案治疗效果分析[J]. 陕西医学杂志,2019,48(12):1660-1662,1666. DOI:10.3969/j.issn.1000-7377.2019.12.022.
[24] 陈鹏,刘冰,魏博,等. 老年口腔颌面颈部多间隙感染的诊治分析[J]. 中华老年口腔医学杂志,2021,19(3):145-148. DOI:10.19749/j.cn.cjgd.1672-2973.2021.03.004.
[25] 刘冰,吴莹莹,朱晓茹,等. 重型口腔颌面颈部多间隙感染的诊治分析[J]. 空军医学杂志,2021,37(5):448-449. DOI:10.3969/j.issn.2095-3402.2021.05.023.
[26] 孙静,徐亿普,田宝莹,等. 糖尿病并发颌面颈部间隙感染患者临床资料的回顾性分析[J]. 兰州大学学报(医学版),2015,41(5):49-52. DOI:10.13885/j.issn.1000-2812. 2015.05.010.

颈深部感染患者临床特征及高危并发症的影响因素分析

Clinical characteristics and risk factors of high-risk complications in patients with deep neck infections

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