摘要
目的探讨超声引导经皮颌下区穿刺置管引流(percutaneous submandibular region puncture and drainage,PSPD)在咽旁间隙脓肿(parapharyngeal space abscess,PPSA)治疗中的可行性和安全性。方法回顾性分析2015年1月至2019年12月天津市第三中心医院接受PSPD治疗的26例PPSA患者的临床资料。结果26例患者均穿刺置管成功,一次穿刺置管成功率100%,置管后12~24 h疼痛症状缓解,24~48 h体温恢复正常,48~96 h白细胞及C反应蛋白恢复到正常范围,带管时间为5~14 d,平均7 d。患者术前与术后7 d体温、脓肿最大径、白细胞计数、C反应蛋白比较差异有统计学意义(均P<0.001)。未出现重要血管、神经、腺体损伤等严重并发症。细菌培养阳性18例,最常见的细菌为溶血性链球。结论PSPD治疗PPSA是一种有效、安全、微创的方法,可以作为一种手术切开引流的替代方法。
Objective To investigate the feasibility and safety of ultrasound-guided percutaneous submandibular region puncture and drainage(PSPD) for treating parapharyngeal space abscess (PPSA).Methods The clinical data of 26 patients with PPSA receiving PSPD from January 2015 to December 2019 in the Third Central Hospital of Tianjin were retrospectively analyzed.Results All 26 patients successfully underwent puncture and catheterization with a primary success rate of 100%. After catherization, pain relieved within 12-24 hours, body temperature returned to normal within 24-48 hours, white blood cell(WBC) and C-reactive protein(CRP) returned to normal within 48-96 hours. The catheterization duration ranged from 5 to 14 days and the average time was 7 days. There were statistically significant differences in the body temperature, maximum abscess diameter, WBC and CRP between pre-operation and 7 days after operation(all P<0.001). None of the 26 patients experienced any serious complications such as major vessels, nerve or glands injury. Bacterial cultures were positive in 18 patients and the most common bacteria was hemolytic streptococcus.Conclusions PSPD is an effective, safe and minimally invasive method for the treatment of PPSA as an alternative to operative incision and drainage.
作者
王彦冬
郝凯飞
经翔
李丹
秦正义
丁建民
张鹏
Wang Yandong;Hao Kaifei;Jing Xiang;Li Dan;Qin Zhengyi;Ding Jianmin;Zhang Peng(Department of Ultrasound,the Third Central Hospital of Tianjin,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China;Department of Otolaryngology,the Third Central Hospital of Tianjin,Tianjin 300170,China;Tianjin Medical University,Tianjin 300170,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第11期977-981,共5页
Chinese Journal of Ultrasonography
关键词
超声检查
咽旁间隙
脓肿
颌下区
经皮穿刺
置管引流
Ultrasonography
Parapharyngeal space
Abscess
Aubmandibular region
Percutaneous puncture
Catheter drainage
