【摘要】 目的 :总结牙源性下行性坏死性纵隔炎的临床表现、发病机制、诊断和治疗方法 ,以提高该病的早期诊断率及治愈率。方法:回顾分析了5例牙源性坏死性纵隔炎的临床资料,男2例,女3例,平均年龄54.6岁。病因分析,下颌智齿冠周炎3例,上、下颌磨牙根尖脓肿各1例。均据临床表现、脓液细菌培养、CT等检查明确诊断。积极采用经颈或联合颈胸手术切开引流,其中经颈切开引流3例,应用胸腔镜行胸部引流2例。同时进行全身抗感染、营养支持等治疗。结果:5例患者经及时手术和药物治疗,出院前复查胸部CT,显示纵隔恢复正常,均痊愈出院,住院时间23~51 d,平均29.2 d。结论:牙源性下行性坏死性纵隔炎的病情发展迅速,早期确诊、及时切开引流是治疗成功的关键。更多还原

【Abstract】 Objective: To review and summarize the clinical characteristics and treatment outcomes of odontogenic descending necrotizing mediastinitis(ODNM). Methods: Five ODNM patients were retrospectively analyzed. 2 males and 3 females with a median age of 54.6 years. 3 patients had mandibular wisdom teeth pericoronitis and 2 patients had periapical abcess of molars. The diagnosis measures included clinical examination, CT scan, and bacteriological culture. Treatments consisted of antibiotic administration and aggressive transcervial(3 cases) and/or transthoracic surgical mediastinal drainage(2 cases). Patients hospitalized from 23 to 51 days, and the average stay was 29.2 days. Results: All patients achieved satisfactory recovery. Conclusion: Diagnosis without delay and aggressive surgical mediastinal drainage are significant in control of ODNM.更多还原