中文摘要：

目的探讨颌面部颈部筋膜间隙医院感染及多层螺旋CT诊断意义,为临床诊断治疗提供参考。方法选择2009年7月-2014年3月在医院接受诊治的52例颌面部颈部筋膜感染患者,其行手术后采集引流脓汁进行细菌培养,同时进行厌氧菌培养;观察多层螺旋CT诊断表现及蔓延途径,应用软件SPSS19.0进行数据处理分析。结果 52例感染患者标本中培养出病原菌59株,前3位病原菌依次为肺炎克雷伯菌13株、酿脓链球菌16株、咽峡炎链球菌8株,分别占22.03%、27.11%、13.56%;多层螺旋CT诊断52例患者感染呈蜂窝织炎或脓肿,脓肿CT表现为脓肿壁环形强化,脓腔呈低密度;蜂窝组织炎CT表现为受累肌肉增厚肿大,边界模糊;受累部位的皮肤水肿增厚,筋膜间隙内脂肪消失;52例患者筋膜间隙感染包括咀嚼肌间隙感染27例、口底间隙感染12例、颈动脉间隙脓肿感染10例、扁桃体周围间隙感染3例。结论颌面部颈部筋膜间隙感染应用多层螺旋CT诊断准确性高,且该诊断显示蔓延途径,具有重要临床价值。

英文摘要：

OBJECTIVE To investigate nosocomial infections of interfascial space in maxillofacial and neck part and diagnostic significance of multi - slice spiral CT to provide reference for clinical diagnosis and treatment . METHODS Totally 52 patients with interfascial space infections in maxillofacial and neck part admitted and treated in the hospital during Jul .2009 to Mar .2014 were enrolled and their drainage pus after operation was collected for bacterial culture and simultaneously anaerobic culture .The performance of multi‐slice spiral CT diagnosis and the spread ways were observed .The software SPSS19 .0 was used for data analysis .RESULTS The 52 cases of patients with nosocomial infections had 59 strains of pathogens cultured from the specimens with pathogens ranking the top three including 13 strains of K lebsiella pneumoniae accounting for 22 .03% ,16 strains of Streptococcus pyogenes accounting for 27 .11% ,and 8 strains of Streptococcus anginosus accounting for 13 .56% .Multi‐slice spiral CT diagnosed that the 52 patients were infected with cellulitis or abscess .CT of abscess showed abscess wall ring enhancement ,with low density of vomicae .CT of cellular inflammation showed thickening and swelling of the affected muscles with fuzzy boundaries and the skin of affected parts had edema and thickness and the fat in fascial space disappeared .The 52 patients with interfascial space infection included 27 patients with masseteric space infection ,12 patients with mouth floor space infection ,10 patients with infection of carotid space abscess ,and 3 patients with space infection around tonsil .CONCLUSION Multi‐slice spiral CT has high accuracy for diagnosis of interfascial space infection in maxillofacial and neck part ,and the diagnostic CT can display spread ways ,which has important clinical value .