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颈部腐败坏死性蜂窝织炎较常见,并发颈外动脉破裂者不多见,我们遇到一例,报告如下: 患儿康某,女,8个月。因发热12天,左颌颈部肿胀10天,溃烂5天入院。查体:T38.7℃,消瘦,半嗜睡状态;心、肺(一),肝脾未触及;局部情况:左颌后区及颈上部肿胀,左下颌角下后方有一不规则的约4×3 cm之皮肤及皮下组织缺损创面,颌下腺后部及胸锁乳突肌上部暴露,呈暗灰色,自胸锁乳突肌前缘深部有稀薄的灰黄色脓液溢出,恶臭;皮下呈空腔,擦拭空腔有少量坏死组织脱出,无出血,张口正常,口底粘膜无水肿。咽侧壁无膨隆。化验:白细胞47900/mm~3,中性88％,淋巴12％,血红蛋白10.09％;细菌培养(一),胸透正常。临床诊
Necrosis of neck necrosis of the more common cellulitis, complicated by external carotid artery rupture are rare, we encountered a case, the report is as follows: Kang children, female, 8 months. Due to fever for 12 days, the left jaw swelling of the neck for 10 days, 5 days admitted to hospital fester. Check the body: T38.7 ℃, weight loss, half lethargy state; heart and lung (a), liver and spleen not touched; local conditions: left posterior region and upper neck swelling, anterior left mandibular angle an irregular about 4 3 cm of skin and subcutaneous tissue defects in the wound, submandibular gland posterior and sternocleidomastoid upper exposed, dark gray, since the deep edge of the sternocleidomastoid muscle thin yellowish pus overflow, odor; subcutaneous cavity , Wipe the cavity a small amount of necrotic tissue prolapse, no bleeding, normal mouth, mouth mucosa without edema. Pharyngeal wall without bulging. Laboratory tests: white blood cells 47,900 / mm ~ 3, 88% neutral, lymphatic 12%, hemoglobin 10.09%; bacterial culture (a), thoracic normal. Clinical diagnosis