CAJ | 학술논문

目的通过回顾9例下行性坏死性纵隔炎患者的临床资料,总结其诊断及治疗的经验,以期提高治愈率,改善预后.方法 2005年12月至2008年12月共收治9例下行性坏死性纵隔炎患者,均为男性,年龄38-78岁,平均55.7岁,其中8例接受手术治疗,采用颈根部横切口引流4例,颈胸联合切开引流4例.结果 9例中2例死亡,其中1例未接受手术治疗,另1例因术后并发多器官功能衰竭死亡,其余7例均治愈出院.结论诊断和治疗不及时是导致下行性坏死性纵隔炎高病死率的主要原因,各学科相互合作及早期外科干预可以降低其病死率,提高疗效.
목적 통과회고9례하행성배사성종격염환자적림상자료,총결기진단급치료적경험,이기제고치유솔,개선예후.방법 2005년12월지2008년12월공수치9례하행성배사성종격염환자,균위남성,년령38-78세,평균55.7세,기중8례접수수술치료,채용경근부횡절구인류4례,경흉연합절개인류4례.결과 9례중2례사망,기중1례미접수수술치료,령1례인술후병발다기관공능쇠갈사망,기여7례균치유출원.결론 진단화치료불급시시도치하행성배사성종격염고병사솔적주요원인,각학과상호합작급조기외과간예가이강저기병사솔,제고료효.
Objective To report nine cases of descending necrotizing mediastinitis(DNM)and to summarize the management experience.Methods Between December 2005 and December 2008,nine patients(mean age,55.7 years;age range,38 to 78 years)with DNM were treated.Eight patients underwent surgical drainage of the involved cervical region and mediastinum(4 with cervical drainage alone;4 with cervical drainage and right thoracotomy).Results Two patients died,one of them refused surgical therapy and the other one died of multiorgan failure related to postoperative septic shock.Seven patients recovered.The mortality rate was 22%.Conclusions Delayed diagnosis and inadequate drainage are the main causes of high mortality rate of DNM.Aggressive surgical drainage and debridement of the neck and mediastinum by a multidisciplinary team of surgeons are very important in the treatment of DNM.