下行性坏死性纵隔炎是由牙源性或颈部感染沿颈筋膜扩散侵及纵隔所致的急性纵隔炎,其临床特点为发病罕见、病情危重、进展迅速和病死率高,发病过程与颈、纵隔的解剖生理特点有密切的关系。早期诊断和有效的治疗可降低病死率,胸部CT检查是早期诊断该病的有效方法;早期、足量应用广谱抗生素,根据胸部CT分型采取个体化的及时切开引流、冲洗,彻底清除坏死组织是降低病死率的有效手段,必要时应会同各有关科室,如口腔、头颈外科、胸外科、重症监护、感染科等协同处理治疗;同时对易导致下行性坏死性纵隔炎发生和恶化的原有全身系统性疾病,如糖尿病以及体质不良者,应加以关注和治疗,以降低致死并发症的发生率,提高治疗效果。 Necrotizing mediastinitis is caused by odontogenic or cervical infection along the neck and fascia spread of mediastinal acute mediastinitis caused by its clinical features of rare, critically ill, rapid progress and high mortality, the incidence of The anatomic and physiological characteristics of the neck and mediastinum are closely related. Early diagnosis and effective treatment can reduce the mortality rate, chest CT examination is an effective method of early diagnosis of the disease; early enough broad-spectrum antibiotics, according to the chest CT type to take an individual timely dissection and drainage, flushing, thorough removal Necrosis tissue is an effective way to reduce the mortality rate. If necessary, it should be co-treated with various departments such as oral cavity, head and neck surgery, thoracic surgery, intensive care and infection department. At the same time, necrotizing mediastinitis Of the original systemic diseases, such as diabetes and poor health, should be concerned about and treatment to reduce the incidence of fatal complications and improve the treatment effect.