上颌骨复合性损伤的救治和效果分析

Treatment and effective analysis on maxillary complex injury

目的分析上颌骨复合性损伤的病例特点,总结临床急救过程中的经验教训,评价不同方法治疗上颌骨复合性骨折的临床效果,探讨治疗过程中的失败原因。方法对152例上颌骨复合性损伤病例进行回顾性分析。结果 2例(1.32%)患者在抢救治疗中死亡,150例生存患者的治愈率为62.67%(94/150)。上颌骨闭合性骨折的治愈率高于开放性骨折(P<0.05),内固定手术的治愈率高于保守治疗(P<0.05),Ⅰ期手术治愈率明显高于Ⅱ期手术(P<0.01)。结论上颌骨复合性损伤患者急救失败的主要原因是出血和窒息,治疗效果受治疗时间、手术进路、治疗方法等多种因素影响,及早施行坚强内固定并注意保护和恢复受损脏器组织的功能是治疗成功的关键。

Objective To analyze the characteristics of cases of maxillary complex injury,to sum up experiences and lessons in the clinical first aid process,to evaluate different treatment effects of maxillary complex fracture and investigate the reasons for the failure of the treatment process.Methods 152 cases with maxillary complex injury were analyzed retrospectively.Results 2 cases（1.32%） died during emergency treatment.The cure rate was 62.67%（94/ 150） in the 150 survival cases.The cure rate of closed fractures were better than open ones and surgical treatments than non-surgical ways（P0.05）;the cure rate of surgical treatment in stage Ⅰ was higher than Ⅱ（P0.01）.Conclusion For patients with complex injuries of maxillary,first aid failure is mainly due to bleeding or asphyxiation.Therapeu-tic efficacy is influenced by treatment time,surgical approach,type of treatment and so on.The key to success of treatment is dependent on the early firm internal fixation and the functional protection and restoration of injured organs or tissues.