CAJ | 학술논문

目的：回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法：对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用（种类及疗程）、手术干预及转归等方面进行总结及系统性分析。结果：男女比例为2．4∶1，年龄10～93岁（平均46．23岁），农村城市比例为3∶1。14．6％患者初步诊断不准确。31％患者在发病后5 d 内就诊。82．9％患者为牙源性感染，35％患者初诊时炎症已扩散至咽旁间隙、翼下颌间隙或者合并颈部感染，7．5％患者感染扩散至纵膈；2例患者入院后已合并严重纵膈及肺部感染，转呼吸内科治疗，1例因肾衰转泌尿外科治疗；38例患者入院后及时给予静脉滴注抗生素抗感染治疗、尽早完成切开引流，痊愈出院，平均住院21 d。结论：牙源性感染的重症口底多间隙感染最多见，其治疗的关键在于早期诊断，维持呼吸道通畅，选择合适的抗生素，尽早切开引流、综合治疗去除病因。
목적：회고성분석41례구저중증다간극감염환자적림상진치자료。방법：대환자성별、년령、류행병학특정、감염적유인、증상、초보진단、중요반발질병、합병증、림상진단、항생소적사용（충류급료정）、수술간예급전귀등방면진행총결급계통성분석。결과：남녀비례위2．4∶1，년령10～93세（평균46．23세），농촌성시비례위3∶1。14．6％환자초보진단불준학。31％환자재발병후5 d 내취진。82．9％환자위아원성감염，35％환자초진시염증이확산지인방간극、익하합간극혹자합병경부감염，7．5％환자감염확산지종격；2례환자입원후이합병엄중종격급폐부감염，전호흡내과치료，1례인신쇠전비뇨외과치료；38례환자입원후급시급여정맥적주항생소항감염치료、진조완성절개인류，전유출원，평균주원21 d。결론：아원성감염적중증구저다간극감염최다견，기치료적관건재우조기진단，유지호흡도통창，선택합괄적항생소，진조절개인류、종합치료거제병인。
Objective:To analyze clinical data of 41 patients with severe mouth floor cellulitis.Methods:Patient's gender,age, epidemiological characteristics,origin of inflammation,symptoms of the disease,primary diagnosis,concomitant diseases,complica-tions,clinical diagnosis,the use of antibiotics (type and course),operation and outcomes were reviewed.Results:The male-fe-male ratio of the patients was 2.4∶1 .Age distribution was 1 0 -93 years old(with the mean of 46.23).The cases from urban-rural area was 3∶1 ,1 4.6% of the patients'primary diagnosis was not accurate.Only 31 % of the patients went to doctors in the first 5 days from the beginning of the disease.82.9% of the mouth floor cellulites were odontogenic.35% of the cases were diagnosed to be in-fectious diffusion to parapharyngeal,pterygomandibular spaces or to be complicating with neck infection at first examination.Infec-tion of 7.5% of the cases were spread to mediastinum.All the patients were administered with antibiotics and completed the surgical drainage as early as possible,except 2 transfered to respiratory medicine for mediastinum serious mediastinal and pulmonary infection and 1 to urinary surgery for renal failure.Conclusion:Odontogenic infection is most common for mouth floor cellulitis.Accurate di-agnose,maintenance of airway and initiate suitable antibiotics are rery important for the treatment of severe cellulitis of mouth floor. Prompt surgical drainage and comprehensive treatments are also essential to prevent patients from severe complications.