食管异物穿孔致颈深间隙感染及纵隔脓肿的诊治

葛鑫颖; 刘良发; 路承; 张奥博; 王振晓

doi:10.13201/j.issn.1001-1781.2018.04.012

食管异物穿孔致颈深间隙感染及纵隔脓肿的诊治

- 首都医科大学附属北京友谊医院耳鼻咽喉头颈外科(北京, 100050)
基金项目:
北京市教育委员会科技发展计划面上项目（No：KM201510025028）

详细信息

通讯作者: 刘良发,E-mail:liuliangfa301@163.com

中图分类号: R768.4

收稿日期: 2017-12-19

The diagnosis and treatment of neck abscess and mediastinal abscess following esophageal perforation induced by esophageal foreign body

- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China

More Information

Corresponding author: LIU Liangfa, E-mail: liuliangfa301@163.com

Received Date: 19 December 2017

摘要

摘要: 目的：探讨食管异物穿孔致颈深间隙感染及纵隔脓肿的临床表现、影像学检查及治疗方案。方法：6例食管异物穿孔致颈深间隙感染及纵隔脓肿患者均行颈侧切开探查+颈部脓肿切开引流术，3例并纵隔脓肿者同时行经颈部纵隔脓肿引流术。结果：6例患者均治愈。胃管拔除中位时间11 d （7~30 d）。均未行气管切开。结论：对于可疑穿孔者应尽早行颈胸部CT检查明确异物位置及与周围组织的关系。对于怀疑颈深间隙感染及纵隔脓肿形成者，应及时行手术探查，切开引流，取出异物。
- 异物 /
- 食管穿孔 /
- 颈深间隙感染 /
- 纵隔脓肿 /
- 诊断与治疗
Abstract: Objective: The aim of this study is to discuss the clinical presentation, imaging examination and treatment of neck abscess and mediastinal abscess following esophageal perforation induced by esophageal foreign body.Method: Six patients all underwent lateral neck incision and drainage of neck abscess. Simultaneously, mediastinal abscess drainage was performed in 3 cases with mediastinal abscess.Result: All 6 patients were cured. The median time of extraction of gastric tube was 11 days (7-30 days). All patients were not treated with tracheotomy.Conclusion: Neck and chest CT should be done as soon as possible for suspected patients to definite the location of foreign body and the relationship between foreign body and surrounding structures. Patient who were suspected with neck abscess and mediastinal abscess should undergo surgery to remove foreign body and drain the infectious deep neck and mediastinal spaces as early as possible.
- foreign bodies /
- esophageal perforation /
- neck abscess /
- mediastinal abscess /
- diagnosis and treatment

HTML全文

参考文献(8)

[1]	张亚民, 赵玉林, 娄卫华, 等.食管异物取出术后纵隔脓肿的治疗[J].临床耳鼻咽喉头颈外科杂志, 2010, 24(9):392-393.
[2]	SAFRANEK J, GEIGER J, KLECKA J, et al.[Mediastinitis after esophageal perforation] [J].Rozhl Chir, 2013, 92:195-200.
[3]	李四军, 潘庆春, 严达忠, 等.食管异物312例临床分析[J].临床耳鼻咽喉头颈外科杂志, 2017, 31(7):556-559.
[4]	肖帆, 罗礼云.超声诊断异物性食管穿孔并周围脓肿形成1例[J].中国医学影像技术, 2016, 32(2):301-301.
[5]	程国涛, 袁劲松.CT图像三维重建在食管异物诊断中的应用价值[J].医疗卫生装备, 2016, 37(9):88-90.
[6]	WHITE R K, MORRIS D M.Diagnosis and management of esophageal perforations[J].Am Surg, 1992, 58:112-119.
[7]	SANCHETI M S, FERNANDEZ F G.Surgical Management of Esophageal Perforation[J].Oper Tech Thoracic Cardiovascular Surg, 2015, 20:234-250.
[8]	陈宽冰, 宣莹, 石文君, 等.纵隔脓肿的治疗[J].临床肺科杂志, 2013, 18(8):1518-1519.