异物致颈部脓肿三例并文献复习

doi:10.6040/j.issn.1673-3770.0.2016.341

摘要/Abstract

摘要： 目的探讨异物所致颈部脓肿临床特点、诊断及治疗方式,提高对异物所致颈部脓肿的诊治水平。方法回顾性分析3例异物所致颈部脓肿患者并同期所有中、英文类似报道病历资料,共49例。结果 49例中采用手术治疗48例,术中发现并取出异物46例;保守治疗1例;发生呼吸骤停等并发症17例,所有报道病例均治愈出院。结论异物所致颈部脓肿病情危重,并发症较多。结合病史及影像学检查,发现并取出异物,尽早颈部脓肿引流是治疗关键。

关键词: 并发症, 异物, 颈部脓肿, 引流

Abstract: Objective To explore the clinical characteristics, diagnosis and treatment of cervical abscess caused by foreign bodies. Methods Clinical data of 3 cases of cervical abscess caused by foreign body treated during 2012 and 2015 were retrospectively analyzed, and 49 similar cases were reviewed. Results Of the 49 cases, 48 received surgical treatment, and 46 had foreign bodies removed; 1 case received conservative treatment. Complications such as respiratory arrest occurred in 17 cases. All reported cases were cured. Conclusion Cervical abscess caused by foreign bodies is a critical condition with many complications. The key steps involve detecting and removing foreign bodies based on the history and imaging studies, and draining the abscess as soon as possible.

Key words: Foreign body, Drainage, Neck abscess, Complication

中图分类号:

R766.9

吴博,胡国华. 异物致颈部脓肿三例并文献复习[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 100-102.

参考文献

[1] Ziad T, Rochdi Y, Benhoummad O, et al. Retropharyngeal abscess revealing a migrant foreign body complicated by mediastinitis: a case report[J]. Pan Afr Med J, 2014, 3(19):125.
[2] 项海杰, 陈波蓓, 黄赛瑜, 等. 食管异物伴脓肿的救治[J]. 中国耳鼻咽喉头颈外科杂志, 2014, 21(2):99-100. XIANG Haijie, CHEN Bobei, HUANG Saiyu, et al. Esophageal foreign body with abscess treatment[J]. Chin Arch Otolaryngol Head Neck Surg, 2014, 21(2):99-100.
[3] Pai K, Pillai S, Bhandarkar A, et al. Migrating ingested foreign body of the upper aerodigestive tract with resultant septic shock[J]. Sultan Qaboos University Med J, 2013, 11(13):606-610.
[4] 余巧, 王进, 何跃, 等. 食管后壁异物伴脓肿1例[J]. 西南国防医药, 2013, 23(12):1392. YU Qiao, WANG Jin, HE Yue, et al. Wall after esophageal foreign body with abscess in 1 case[J]. Southwest National Defense Med, 2013, 23(12):1392.
[5] 杨磊, 程印蓉. 食管异物穿孔致颈部皮下脓肿一例[J]. 实用医学影像杂志, 2014, 15(3):227-228 YANG Lei, CHENG Yinrong. Esophageal foreign body perforation induced cervical subcutaneous abscesses in 1 case[J]. Prac Med Image Mag, 2014, 15(3):227-228.
[6] 上官翰京, 高兴强, 陈乌娜, 等. 异物性咽后脓肿临床分析[J]. 山东大学耳鼻喉眼学报, 2014, 28(1):65-66. SHANGGUAN Hanjing, GAO Xingqiang, CHEN Wuna, et al. Analysis of foreign body induced retropharyngeal abscess[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014, 28(1):65-66.
[7] 徐建, 徐永生, 姜春峰, 等. 下咽异物致颈深部脓肿的诊治[J]. 齐鲁医学杂志, 2012, 27(6):516-518. XU Jian, XU Yongsheng, JIANG Chunfeng, et al. Diagnosis and treatment of deep neck abscess caused by hypopharyngeal foreign body[J]. Med J Qilu, 2012, 27(6):516-518.
[8] Jha SK, Kumar SP, Somu L, et al. Missing fish bone: case report and literature review[J]. Am J Otolaryngol, 2012, 33(5):623-626.
[9] Costa L, Larangeiro J, Pinto Moura C, et al. Foreign body ingestion: rare cause of cervical abscess[J]. Acta Med Port, 2014, 27(6):743-748.
[10] 邵剑波, 刘大波, 钟建文, 等. 异物致婴幼儿咽后壁脓肿11例[J]. 实用医学杂志, 2013, 29(15):2589-2590. SHAO Jianbo, LIU Dabo, ZHONG Jianwen, et al. Foreign body to infants and young children pharynx posterior wall abscess in 11 cases[J]. Prac Med J, 2013, 29(15):2589-2590.
[11] Vourexakis Z, Konu P. Retropharyngeal abscess complicating ‘innocent’ foreign body ingestion[J]. BMJ Case Rep, 2014, 23:pii: bcr2014204010.
[12] Vallamkondu V, Carlile S, Shakeel M, et al. Neck abscess and vocal cord paresis: delayed complications of a self-extruded long fishbone stuck in throat[J]. BMJ Case Rep, 2013, 18: pii: bcr2013201832.
[13] 冯刚, 罗前程, 姚峪岚, 等. 巨大咽后壁脓肿并发呼吸心跳骤停救治成功1例[J]. 实用医学杂志, 2014, 30(4):674. FENG Gang, LUO Qiancheng, YAO Yulan, et al. Huge pharynx posterior wall abscess complicated with respiratory cardiac arrest treatment success in 1 case[J]. Prac Med J, 2014, 30(4):674.
[14] Chen CY, Peng JP. Esophageal fish bone migration induced thyroid abscess: case report and review of the literature[J]. Am J Otolaryngol, 2011, 32(2):253-255.
[15] 游龙贵, 张克辉, 张小安, 等. 食管异物术后再发颈胸段食管脓肿二例分析及处理[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(3):215-217 YOU Longgui, ZHANG Kehui, ZHANG Xiaoan, et al. Clinical analysis and treatment of 2 examples of recurrent esophgeal abscess around neck and breast part from operations for extraction of foreign body in esophagus[J]. Chin J Otorhinolaryngol Head Neck Surg, 2016, 51(3):215-217.
[16] Shah R, McLear PW. Neck abscess caused by feather foreign body[J]. Otolaryngol Head Neck Surg, 2013, 149(3):515-516.
[17] De Pietro J, Devaiah A. Endoscopic removal of esophageal foreign body and drainage of thyroid abscess[J]. Am J Otolaryngol, 2013, 34(2):151-153.
[18] Chung SM, Kim HS, Park EH. Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones[J]. Eur Arch Otorhinolaryngol, 2008, 265(9):1125-1129.
[19] Akazawa Y, Watanabe S, Nobukiyo S, et al. The management of possible fishbone ingestion[J]. Auris Nasus Larynx, 2004, 31(4):413- 416.
[20] 王丽, 邱英伏, 周玉英, 等. 颈侧切开治疗颈段食管嵌顿性异物三例[J]. 中华耳鼻咽喉头颈外科杂志, 2005, 40(12):950. WANG Li, QIU Yingfu, ZHOU Yuying, et al. The neck segment esophageal embedded foreign bodies treated by lateral neck incision in 3 cases[J]. Chin J OtoRhinolaryngol Head Neck Surg, 2005, 40(12):950.
[21] 古庆家, 樊建刚, 李静娴, 等. 食管异物并发食管穿孔及颈部脓肿临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(7):459-461. GU Qingjia, FAN Jiangang, LI Jingxian, et al. Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body[J]. J Clin Otorhinolaryngol Head Neck Surg(Chin), 2014, 28(7):459-461.
[22] 童红玉, 李泉水. 超声诊断甲状腺异物并发局部炎症2例[J]. 中国超声医学杂志, 2012, 28(2):187. TONG Hongyu, LI Quanshui. The ultrasonic diagnosis of thyroid eye winker concurrent local inflammation in 2 cases[J]. Chin J Med Ultrasound, 2012, 28(2):187.
[23] 刘斌, 江育玲, 彭建辉, 等. 颈侧切开术在颈段食管异物取出中的应用[J]. 中国耳鼻咽喉颅底外科杂志, 2011, 17(4):268-271. LIU Bin, JIANG Yulin, PENG Jianhui, et al. Application of lateral neck incision to the removal of the cervical esophageal foreign body[J]. Chin J Otorhinolaryngol Skull Base Surg, 2011, 17(4):268-271.

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