深頸部膿瘍症例の臨床統計

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タイトル別名
  • Clinical Study of Deep Neck Abscesses
  • 臨床 深頸部膿瘍症例の臨床統計
  • リンショウ シンケイブ ノウヨウショウレイ ノ リンショウ トウケイ

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We retrospectively analyzed the clinical characteristics of 41 consecutive patients with deep neck abscesses who were treated in our department between 1999 and 2011. The patients comprised 27 males and 14 females ranging in age from 4 to 88 years. Seven of them developed descending mediastinitis (mediastinum group), while the other 34 did not (neck group). The mediastinum group had a significantly longer hospitalization period (49.6±23.3 days vs. 20.9±11.2 days, p<0.001), higher serum CRP (26.3±10.9 mg/dl vs. 12.9±10.0 mg/dl, p=0.009), higher percent of patients who underwent tracheostomy (85.7% vs. 17.6%, p<0.001), and a higher detection rate of Streptococcus milleri group bacteria (71.4% vs. 23.5%, p=0.013) compared to the neck group. The percentage of patients with diabetes mellitus was on the higher side in the mediastinum group than in the neck group (42.9% vs. 14.7%, p=0.087). Diabetic patients were prone to develop mediastinitis (3/8 vs. 4/33, p=0.087), and showed a significantly longer hospitalization period (42.0±20.5 days vs. 21.8±15.0 days, p=0.004), higher white blood cell count (17160±5908/μl vs. 13045±6734/μl, p=0.041), and a higher percent of patients who underwent tracheostomy (62.5% vs. 21.2%, p=0.021) compared to nondiabetic patients. These results suggest that underlying diabetes mellitus and/or infection with S. milleri group bacteria are possible predisposing factors for the aggravation and prolongation of deep neck abscesses.<br>

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