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  • 岳 磊,石 崧.影响咽部间隙脓肿切开引流时机的多因素分析[J].同济大学学报(医学版),2022,43(1):85-89.    [点击复制]
  • YUE Lei,SHI Song.Multivariate analysis of timing for incision and drainage of pharyngeal abscess[J].同济大学学报(医学版),2022,43(1):85-89.   [点击复制]
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影响咽部间隙脓肿切开引流时机的多因素分析
岳磊,石崧
0
(上海交通大学医学院附属同仁医院耳鼻咽喉科,上海 200336)
摘要:
目的 探讨影响咽部间隙脓肿切开引流的相关危险因素。方法 回顾性分析2016年7月—2020年7咽部间隙脓肿患者80例,男64例(80%),女16例(20%),男女比例为4∶1,根据治疗方式不同分为颈部脓肿切开引流组(n=36)和药物保守治疗组(n=44),将治疗方式作为自变量,采用Logistic回归模型筛选影响颈部间隙脓肿切开引流时机的相关危险因素。结果 79例经药物保守治疗及手术治疗痊愈,1例死亡。在α=0.05的水准,白细胞持续升高、咽痛时间增加、脓肿最大直径>1.8 cm是影响脓肿切开引流的临床危险因素(β=2.439,OR=11.459;β=0.356,OR=1.428;β=2.852,OR=17.325)。性别、年龄、血糖控制情况、脓肿位置、抗生素使用情况、免疫系统疾病史、纵隔感染等不是咽部间隙脓肿切开引流的危险因素。结论 脓肿直径>1.8 cm、白细胞变化情况以及就诊时咽痛时间是需要脓肿切开引流的危险因素。当脓肿直径>1.8 cm时应及时切开引流,但脓肿直径1~1.8 cm需综合考虑白细胞变化情况,若白细胞持续升高也需切开。脓肿直径<1 cm时可通过保守治疗使脓肿吸收。
关键词:  咽部间隙  脓肿  危险因素  颈部感染  切开引流
DOI:10.12289/j.issn.1008-0392.21189
投稿时间:2021-05-11
基金项目:上海市长宁区科学技术委员会科研项目(CNKW2017Y04);上海市同仁医院国自然青年项目助推计划(TRYJ(JC)201805)
Multivariate analysis of timing for incision and drainage of pharyngeal abscess
YUE Lei,SHI Song
(Department of Otolaryngology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China)
Abstract:
Objective To investigate the factors related to the timing of incision and drainage of pharyngeal abscess. Methods Clinical data of 80 with pharyngeal space abscess(64 males and 16 females) were analyzed retrospectively. There were 36 patients treated with Incision and drainage of cervical abscess(incision group) and 44 patients receiving expectant medical treatment(medication group). Logistic regression model was used to screen the factors related to timing of incision and drainage of cervical abscess. Results Seventy-nine patients recovered after conservative medical treatment or surgical treatment, and one died. Multivariate logistic analysis showed that continuous increase of WBC, increased time for pharyngodynia, the maximum diameter of abscess >1.8 cm were factors related to the timing of abscess incision and drainage(β=2.439,OR=11.459;β=0.356,OR=1.428;β=2.852,OR=17.325); while sex, age, glucose control, abscess location, antibiotic use, history of immune system disease, and mediastinal infection were not related to timing of incision and drainage of pharyngeal space abscess. Conclusion For patients with pharyngeal space abscess, the diameter of abscess >1.8 cm, the leukocyte abnormality and the time of pharyngodynia are the factors of requiring incision and drainage.
Key words:  pharyngeal space  abscess  risk factors  cervical infection  incision and drainage

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