背景:颈面部间隙感染可能危及生命,这需要准确的诊断,早期切口,和足够的排水。计算机断层扫描(CT)在颈面部间隙感染中的应用显着增加,因为它在评估脓肿方面具有优势,其可用性,和低成本。然而,术前CT成像在颈面部间隙感染中的临床价值仍存在争议,因为其特异性差,辐射暴露,潜在的并发症,和额外的费用。我们,因此,探讨CT检查是否应作为颈面部间隙感染患者的常规检查。
方法:对2016年1月至2020年12月在四川大学华西口腔医院接受切开引流术的所有颈面部间隙感染患者进行回顾性研究。将患者分为两组:术前CT组和术前CT组。结果,包括再手术率,漏诊率,症状缓解的日子,逗留时间,手术持续时间,以及住院总费用,进行了分析。
结果:在153名患者中,108例术前CT手术,45例未术前CT手术。术前CT组的再手术率(6/108,5.6%)明显低于未术前CT组(10/45,22.2%)(P=0.00)。漏诊率显著降低(P=0.00),症状缓解天数(P=0.01),停留时间(P=0.03),术前CT组检测到手术时间(P=0.01)。结果表明,术前利用CT可以降低漏诊率和重复手术并发症。
结论:我们建议术前CT作为颈面部间隙感染的常规检查。
BACKGROUND: Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections.
METHODS: A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West
China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed.
RESULTS: Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications.
CONCLUSIONS: We recommend preoperative CT as a routine examination in cervicofacial space infections.