《Journal of Oral and Maxillofacial Surgery》 ›› 2014, Vol. 24 ›› Issue (1): 56-. doi: 10.3969/j.issn.1005-4979.2014.01.012

• Clinical Report • Previous Articles     Next Articles

Odontogenic Descending Necrotizing Mediastinitis: Report of 5 Cases

TONG Yong-qing1, CHEN Shen-guo1, DAI Jie1, SHI Geng-sheng1, YE Zhong-rui2, ZHU Wei3   

  1. 1. Department of Oral and Maxillofacial Surgery, 2. Department of Thoracic Surgery, 3. Intensive Care Unit, Taizhou Hospital , Wenzhou Medical College, Taizhou 317000, Zhejiang Province, China
  • Online:2014-02-28 Published:2014-06-27

牙源性下行性坏死性纵隔炎的临床总结

童永青1,   陈申国1,   戴杰1,   施更生1,   叶中瑞2,   朱蔚3   

  1. 1. 温州医学院附属台州医院口腔颌面外科,2. 心胸外科,3. 重症医学科,浙江   台州   317000
  • 通讯作者: 童永青,副主任医师. E-mail:tongyongqing@yahoo.com.cn
  • 作者简介:童永青(1976—),男,安徽黄山人,副主任医师,硕士. E-mail:tongyongqing@yahoo.com.cn

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.

Key words: odontogenic, descending necrotizing mediastinitis, surgery drainage; diagnosis; treatment

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。

关键词: 牙源性,  ,  , 下行性坏死性纵隔炎,  ,  , 外科引流,  ,  , 诊断,  ,  , 治疗

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