Clinical Statistical Analysis Of 150 Cases Of Maxillofacial And Neck Multiple Space Infections

Objective: To analyze the etiology,diagnosis,treatment methods and risk factors of descending necrotizing mediastinitis in maxillofacial and cervical multi-space infection,and provide theoretical basis for the early detection,diagnosis and treatment of this disease.Research method: The clinical data of patients with maxillofacial and neck multi-space infection and descending necrotizing mediastinitis who were admitted to our hospital from January 2018 to December 2021 were retrospectively collected,and the age,gender,etiology,disease course,onset season,presence of No diabetes and other complications,imaging features,laboratory tests（white blood cell count,neutrophil ratio,neutrophilto-lymphocyte ratio,C-reactive protein,fasting blood glucose,etc.）,microbiological examination,treatment methods and results.The x2 test or fisher’s exact test was used for binary variables,and the t test was used for continuous variables.The variables with p < 0.05 were included in logistic regression analysis to identify the risk factors associated with descending necrotizing mediastinitis.Research result: A total of 150 patients were hospitalized in our hospital from January 2018 to December 2021.A total of 150 patients met the criteria and were included in the study,including 110 male patients and 40 female patients,with a male-to-female ratio of 2.75:1.The ratio of male to female in patients with secondary descending necrotizing mediastinitis was 5.7:1;the ratio of males to females in patients without secondary descending necrotizing mediastinitis was 2.5:1.Odontogenic infection was the most common cause of multi-space infection in the maxillofacial and neck,with a total of 78 cases（52%）,glandular infection in 52 cases（34.67%）,and other infection sources such as trauma or esophageal foreign body in 20 cases（13.33%）.).The collected data were subjected to univariate analysis,and the results showed that albumin（p=0.003）,C-reactive protein（p=0.009）,NLR（p=0.018）,proportion of neutrophils（p=0.043）,Involvement of the parapharyngeal space（p < 0.001）,involving the retropharyngeal space（p < 0.001）was statistically significant.Variables such as albumin,NLR,CRP and the percentage of neutrophils in leukocytes,the involvement of parapharyngeal and retropharyngeal spaces were included,and a multivariate logistic regression equation was constructed.The results showed that involvement of the retropharyngeal space（p<0.001）,involvement of the parapharyngeal space（p=0.033）,and CRP（p=0.031）were associated with secondary DNM,with statistical significance.No statistical difference was found for other variables.It can be considered that parapharyngeal space,retropharyngeal space involvement,and elevated CRP are risk factors for descending necrotizing mediastinitis secondary to multi-space infection in the maxillofacial and neck.Conclusion: 1.Multi-space infection of maxillofacial and neck is a serious infectious disease in the department of otolaryngology.It occurs in middle-aged and elderly people,and there are more male patients.Odontogenic infection is the most common cause of the disease.2.Descending necrotizing mediastinitis is the most common serious complication of this disease,with an incidence of 13%.If patients with secondary DNM are not treated in time,the mortality rate after complicated with sepsis and organ failure is high,up to 25%.Parapharyngeal involvement,retropharyngeal space and elevated CRP were independent risk factors for secondary DNM.In addition,patients should be alert to the occurrence of DNM when the NLR ratio is large,the percentage of neutrophils is increased,and the albumin value is decreased.