심경부감염의 치료에 영향을 줄 수 있는 요인들에 대한 임상 분석
Clinical Analysis of Factors Affecting on Treatment of Deep Neck Infection
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초록
The treatment of deep neck infection is antibiotic therapy followed by surgery when it is indicated. There is no detailed guideline for the treatment according to clinical feature or extension of infection. So the purpose of this study is to find out factors affecting the treatment of deep neck infection in the point of clinical feature, laboratorial study and CT finding. Subjects and Method：We have conducted a retrospective study of 67 patients that had been seen between January 2005 and July 2007. We divided patients into a non-surgical group and a surgical group, analyzed clinical informations and laboratorial tests between the two groups, and studied the relations between lesion size, degree of infection and treatment method. Results：There were significant differences between the non-surgically treated and surgically treated groups. The latter group presented with older age, larger lesion, more numbers of involved spaces, highly elevated WBC counts, more decreased in protein counts and had longer treatment period prior to hospitalization than the former group. Also, the size of the affected lesion was bigger, the incidence of abscess formation higher and required surgical treatment more often. Conclusion：Surgical management has an advantage when the lesion size is more than 7 cm, even if it presents an incomplete abscess. If the laboratory study reveals highly sustained WBC counts after proper antibiotic therapy and low protein counts, more aggressive treatment should be considered, especially for old patients. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:544-8)
Abstract
The treatment of deep neck infection is antibiotic therapy followed by surgery when it is indicated. There is no detailed guideline for the treatment according to clinical feature or extension of infection. So the purpose of this study is to find out factors affecting the treatment of deep neck infection in the point of clinical feature, laboratorial study and CT finding. Subjects and Method：We have conducted a retrospective study of 67 patients that had been seen between January 2005 and July 2007. We divided patients into a non-surgical group and a surgical group, analyzed clinical informations and laboratorial tests between the two groups, and studied the relations between lesion size, degree of infection and treatment method. Results：There were significant differences between the non-surgically treated and surgically treated groups. The latter group presented with older age, larger lesion, more numbers of involved spaces, highly elevated WBC counts, more decreased in protein counts and had longer treatment period prior to hospitalization than the former group. Also, the size of the affected lesion was bigger, the incidence of abscess formation higher and required surgical treatment more often. Conclusion：Surgical management has an advantage when the lesion size is more than 7 cm, even if it presents an incomplete abscess. If the laboratory study reveals highly sustained WBC counts after proper antibiotic therapy and low protein counts, more aggressive treatment should be considered, especially for old patients. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:544-8)
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