儿童急性乳突炎并发症治疗策略

The Complication of Acute Mastoiditis in Children Retrospective Study

潘骏良;杨军;黄琦;

1:上海市嘉定区中心医院

2:上海交通大学医学院附属新华医院耳鼻咽喉-头颈外科

摘要
目的探讨儿童急性乳突炎并发症的治疗策略。方法回顾性分析23例至少并发一项并发症的急性乳突炎患儿的临床资料,包括骨膜下脓肿16例,周围性面瘫5例(其中1例合并骨膜下脓肿),乙状窦血栓1例,骨膜下脓肿、迷路炎及败血症1例,所有并发症均于住院治疗前发生。所有患儿均住院行手术治疗,19例行乳突切开术,3例行改良乳突根治术,1例重症患儿行乳突根治术;其中11例患儿同时行鼓膜置管术,5例面瘫患儿同时行面神经减压术。结果 23例患儿中22例痊愈,1例患儿因并发败血症家属放弃治疗,自行出院后失访。9例患儿取乳突腔分泌物行细菌病原学检查,其中5例肺炎链球菌阳性。结论治疗儿童急性乳突炎并发症的首要目标为清除病灶,应首选手术治疗,辅以全身应用抗生素,绝大部分患儿预后良好,极少数因病灶累及颅内或并发全身症状预后不良。
关键词
儿童;急性乳突炎;并发症;治疗
基金项目(Foundation):
作者
潘骏良;杨军;黄琦;
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潘骏良杨军黄琦