牙外伤463例急诊临床分析

Clinical Investigation of 463 Dental Trauma Patients in Dental Emergency

目的研究急诊牙外伤的流行病学特征和临床特点,为牙外伤的防护和应急处理提供参考。方法回顾2008年1～12月于北京大学口腔医院急诊科就诊的463例牙外伤患者的临床资料,分析患者的性别和时间分布、外伤原因和类型、外伤牙部位和数目、伤后就诊时间等。结果463例患者中,男女比例为1.84∶1。外伤时间春季较少,冬季较多;周末较平时增加。成人在室外受伤人数占93.1%(268/288),5岁以上的儿童有83.6%(92/110)在室外受伤;5岁及5岁以下的儿童有69.2%(45/65)在室内受伤。外伤牙1023颗,其中乳牙112颗,恒牙911颗。受伤牙位左右基本对称,上中切牙最易受累。各类型牙外伤中,冠折为最多见。63.7%的患者累及2颗及2颗以上患牙;71.1%的患者合并不同程度颌面部软组织损伤;大部分患者在牙外伤后24h内到急诊就诊。结论急诊牙外伤常累及多颗牙齿,并伴发不同程度的颌面部软组织损伤,临床应注意避免漏诊;根据牙外伤的发病情况,对不同人群,在不同时间、地点可采用针对性防护措施。

Objective To investigate the epidemiological and clinical characteristics of dental trauma in dental emergency. Methods A comprehensive review including 463 emergency dental trauma visits at the emergency department of Peking university school and hospital of stomatology during a one-year period was performed. General characteristics from the patients including age,gender,time of visit,the cause of dental trauma,places where the dental trauma happened,and diagnoses were analyzed. Results A higher incidence of dental trauma was observed in male than in female. In spring frequency of dental traumatic emergencies was lower than that in winter. Most visits presented on weekends. sixty nine percent of children aged 5 and younger were injured at home,but 83.2% of children older than 5 years and 93.1%adults were injured outside door. The number of injured teeth in left and right side had no significant difference. Maxillary incisors were easily to be affected,especially the maxillary centralincisor. Crown fracture was the most common traumatic type. The combination of dental trauma and oral and maxillofacial soft tissue injury was experienced by 329 patients. Thirty seven percent of the patients presented to the dental clinic within 2 hours after injury,only 5.2% of the patients visited the clinic after 24 hours. Conclusion Dental trauma was one of the common diseases in oral emergency. Knowledge of the epidemiological and clinical characteristics of emergency dental trauma can help us to treat them and to apply preventive measures.