138例头颈部多间隙感染临床分析

Clinical Characteristics of 138 Cases Multi-Space Infections in the Head and Neck

摘要: 目的：回顾性分析头颈部多间隙感染的临床特点、危险因素、治疗预后以及严重并发症。方法：收集2021年1月~2025年6月在浙江大学医学院附属第二医院口腔颌面外科就诊的138例头颈部多间隙感染患者的临床资料，对其病因、治疗方式、术后效果及严重并发症进行分析总计。结果：138例头颈部多间隙感染患者年龄16~84岁(平均年龄48.33岁)，男90例，女48例；牙源性感染是头颈部多间隙感染主要病因；下颌下间隙是最常被累及的颌面部间隙；17例患者出现严重的并发症；平均住院日12.95天，其中20天以上有21例。高龄、合并全身系统性疾病、白细胞大于15 * 10⁹/L是头颈部多间隙感染发生并发症的独立危险因素，差异有统计学意义(P < 0.05)。结论：牙病的早期预防和治疗以及控制基础疾病可以降低头颈部间隙感染发生，减少严重并发症。头颈部多间隙感染主要来源于牙源性感染，主要病原菌为草绿色链球菌，老年患者、合并全身系统性疾病、白细胞大于15 * 10⁹/L患者更容易发生严重并发症。高龄、合并全身系统性疾病、白细胞大于15 * 10⁹/L是头颈部多间隙感染发生并发症的独立危险因素。

Abstract: Purpose: A retrospective study on the etiology, risk factors, treatments, and outcomes of life-threatening complications of multi-space infections (MSI) in the head and neck. Patients and Methods: This was a retrospective cohort study that enrolled a sample of patients with multi-space infections who were referred from January 2021 through June 2025. Clinical history, sociodemographic, treatment pattern, treatment outcomes, and life-threatening complications of patients were evaluated. Results: A total of 138 patients suffered with MSI were included, including 90 males and 48 females, with an age range from 16~84 years (median = 48.33 years). The most common cause of MSI was odontogenic infection. The submandibular space was most commonly involved in MSI. Life-threatening complications were found in 17 patients. Hospital Average Length of Stay was 12.95 days, 21 of them have more than 20 days. Older age and underlying systemic disease, and the white blood cell count >15 * 10⁹/L can increase the risk of life-threatening complications of multi-space infections (LCMIs) in the head and neck. Conclusions: The current review demonstrates potential risk factors of MSI and suggests that early dental extraction and the control of basic diseases can reduce the incidence of MSI. MSI is mainly caused by odontogenic infection, the main pathogens are Streptococcus viridans. The patients who have older age and underlying systemic disease, and the white blood cell count >15 * 10⁹/L can be more commonly developed the risk of life-threatening complications of multi-space infections.