儿童脓肿型与非脓肿型颈部感染性肿块的临床及影像特征分析

doi:10.19871/j.cnki.xfcrbzz.2024.02.001

摘要/Abstract

摘要： 目的回顾性分析脓肿型与非脓肿型颈部感染性肿块患儿的临床及影像学特征,对比脓肿型与非脓肿型患儿颈部感染性肿块的诊治及预后差异。方法收集2016年1月至2023年8月广州医科大学附属妇女儿童医疗中心收治的71例儿童颈部感染病例,根据有无脓肿形成分为脓肿组（49例）和非脓肿组（22例）,对比分析两组患儿的临床与影像特征及治疗方法与预后效果差异。结果脓肿组患儿中,31例有发热症状,42例C反应蛋白（C-reactive protein,CRP）升高;49例均可触及颈部肿块,21例肿块质地软,41例活动度欠佳,18例皮温升高,36例边界模糊;36例累及3个及以上颈部间隙。非脓肿组患儿中,6例有发热症状,9例CRP升高;19例可触及颈部肿块,10例肿块质地韧,16例活动度欠佳,5例皮温升高,8例边界模糊;10例累及3个及以上颈部间隙。脓肿组与非脓肿组颈部感染患儿在是否触及肿块（P=0.008)、肿块质地（P=0.027）、活动度（P=0.031)、皮温是否升高（P=0.022)、CRP是否升高（P<0.001)和病灶边界是否清晰（P=0.003)等临床表现、实验室指标和影像特征的差异有统计学意义。患儿颈部感染原因以梨状窝瘘、淋巴结炎及淋巴管畸形多见。手术治疗结果显示,脓肿组（4.1%）和非脓肿组（9.1%）术后并发症发生率均较低。结论脓肿型颈部感染患儿在发热症状、CRP水平、肿块质地、肿块活动度与皮温、肿块边界不清和颈部间隙受累数量等方面与非脓肿型患儿存在显著差异,CT或MRI增强可为儿童颈部感染的诊断、鉴别诊断及临床治疗方法的选择提供重要参考依据。

关键词: 颈部感染性肿块, 脓肿, 临床表现, 影像特征, 儿童

Abstract: Objective To analyze the clinical and imaging features of the children patients with abscess and non-abscess cervical infectious masses, and compare the differences of diagnosis, treatment and prognosis between the two groups. Method A total of 71 cases of neck infection in children in the Women and Children's Medical Center of Guangzhou Medical University from January 2016 to August 2023 were collected, and they were divided into abscess group (49 cases) and non-abscess group (22 cases) according to the presence or absence of abscess formation.The clinical and imaging characteristics, therapeutic methods and prognosis effects between the two groups were analyzed. Result Among the children with abscess, 31 had fever and 42 had elevated C-reactive protein（CRP）. In 49 cases, the masses were palpable, the texture of the masses was soft in 21 cases, the mobility of the masses was poor in 41 cases, the skin temperature was increased in 18 cases, and the boundaries were blurred in 36 cases. 10 cases involved three or more neck spaces. Among the children with non-abscess, 6 had fever and 9 had elevated CRP. There were palpable neck masses in 19 cases, tough masses in 10 cases, poor mobility in 16 cases, increased skin temperature in 5 cases, and blurred borders in 8 cases. 10 cases involved three or more neck spaces. There were statistically significant differences in clinical manifestations, laboratory parameters and imaging features between the abscess group and the non-abscess group in terms of whether the mass was palpable (P=0.008), the texture of the mass (P=0.027), the activity (P=0.031), the skin temperature (P=0.022), the CRP level(P<0.001), and the lesion boundary(P=0.003). The common causes of neck infection in children patients are piriform fossa fistula, lymphadenitis, and lymphatic malformations. The results of surgical treatment showed that the incidence of postoperative complications was lower in the abscess group (4.1%) and non-abscess group (9.1%). Conclusion Children with abscess neck infection differed significantly from those non-abscess types in terms of clinical and imaging features, and contrast-enhanced, CT or MRI provides an important reference for the diagnosis, differential diagnosis and selection of clinical treatment methods for neck infection.

Key words: Infectious neck mass, Abscess, Clinical presentation, Image feature, Children

中图分类号:

范萌, 尹训涛, 刘光明, 胡悦林. 儿童脓肿型与非脓肿型颈部感染性肿块的临床及影像特征分析[J]. 新发传染病电子杂志, 2024, 9(2): 1-6.

Fan Meng, Yin Xuntao, Liu Guangming, Hu Yuelin. Analysis of clinical and imaging features of abscess and non-abscess cervical infectious masses in children[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(2): 1-6.

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