背景:颈部深部感染的最常见原因是牙齿感染。他们被诊断为体检,影像学检查,超声,或者计算机断层扫描.收集物的外科引流应始终以经典或经皮的方式在早期进行,取决于案件。该研究的目的是比较超声引导下经皮引流技术与一项随机对照试验,在牙源性深宫颈脓肿中进行手术引流。
方法:2015年1月至2019年12月进行了一项随机对照临床试验。住院时间被评估为效率变量。流行病学和次要变量数据(肿瘤,刺耳,发烧,疼痛),白细胞增多,对两种技术的美容效果进行了比较分析。用STATAv14.0进行统计学分析。
结果:分析了128例患者,51名女性和77名男性。平均年龄27.3岁(SD=10.13)。经皮治疗组平均住院时间为3.03天(SD=2.86),手术组平均住院时间为5.46天(SD=2.96)。P值<.001。美容结果显示差异有利于经皮引流组。其他变量均未显示统计学上显著的结果。
结论:应尽早进行手术治疗(宫颈切开术和清创术),并有证据表明深部空间广泛收集。微创图像引导程序是一种替代方案。这些可以在地理位置优越的地方进行,单眼收藏,不会损害患者的气道。必要时采用经皮引流和抽吸技术,连续,或者可以进行排水放置。
结论:对于轻度和/或中度牙体感染患者,超声引导和连续引导经皮引流是最佳治疗选择。
BACKGROUND: The most common cause of deep neck infections is dental infection. They are diagnosed with physical examination, imaging studies, ultrasound, or computed tomography. Surgical drainage of collections should always be performed early in a classical or percutaneous way, depending on the case. The aim of the study was to compare ultrasound-guided percutaneous drainage techniques vs. surgical drainage in deep cervical abscesses of odontogenic origin in a controlled and randomized trial.
METHODS: A randomized controlled clinical trial was performed from January 2015 to December 2019. Hospital stay was evaluated as an efficiency variable. Epidemiological and secondary variable data (tumour, trismus, fever, pain), leukocytosis, cosmetic result comparing both techniques were analysed. Statistical analysis was carried out with STATA v 14.0.
RESULTS: 128 patients were analysed, 51 women and 77 men. Average age 27.3 (SD = 10.13). The percutaneous group had a mean hospital stay of 3.03 (SD = 2.86) days and the surgical group 5.46 (SD = 2.96). The P-value was <.001. Cosmetic results showed differences favouring the percutaneous drainage group. None of the other variables showed statistically significant results.
CONCLUSIONS: Surgical treatment (cervicotomy and debridement) should be undertaken early with evidence of extensive collection in deep spaces. Minimally invasive image-guided procedures are an alternative. These can be performed in well-located, unilocular collections, without compromising of the patient\'s airway. Percutaneous drainage and suction techniques if necessary, serially, or drainage placement may be performed.
CONCLUSIONS: Ultrasound-guided and serially guided percutaneous drainage is the best therapeutic option in patients with mild and/or moderate dental infections.