口腔颌面部间隙感染67例临床治疗分析

Exploration of treatment of maxillofacial space infection

目的:总结分析口腔颌面部间隙感染的临床特征及诊治经验。方法:运用描述性的统计方法,回顾性分析2009年5月～2012年5月收治的口腔颌面部间隙感染的67例患者的临床资料,包括年龄、性别、病因、伴发基础疾病、住院日、感染间隙、临床表现、实验室检查结果、致病菌、治疗要点、疾病发展及治疗效果。结果:患者67例,14例伴DM(20.9%),住院病程平均(9.4±6.3)天,最长33天。牙源性感染30例(44.8%),多间隙感染23例(34.3%)。患者入院后均立即予以抗感染+基础疾病治疗。切开引流52例,单纯抗感染治疗14例。脓液培养示31例有菌生长,链球菌17株(25.3%)。随访2例死于基础疾病,其余患者治疗效果满意。结论:口腔颌面部感染的主要方法是切开引流+抗感染治疗,及时诊断及治疗是治愈的关键,注意全身及局部治疗相结合以减少并发症的发生。

Objective To Analysis the clinical characteristics,diagnosis and management of oral and maxillofacial space infections （maxillofacial space infections MSI）. Methods A retrospective review was conducted of the clinical data of the patients who were diagnosed as having MSI in the department of oral and maxillofacial surgery in our hospital from 2009,05 to 2012,05,Including demographics,etiology, associated systemic diseases,duration of hospitalization,clinical manifestations,bacteriology,treatment,anti-infection,nutrition support,laboratory data,outcomes.Descriptive statistics were computed for all variables. Results 67 patients were recorded;45（67.2%）were men, with a of mean age （47.5＋16） years .There were 14 patients （20.9%） who had diabetes mellitus （DM）.Streptococcus viridans and Staphylococcus aureus were the most common organisms （25.3%,11.9%） identified through pus cultures.Their hospitalization duration was （9.4＋6.3）d,The longest is 33 days. The Multiple spaces was most commonly involved （34.3%）and odontogenic infections was the most common cause of MSI （44,8%）.AII patients were immediately given anti-infection and treatment of underlying diseases after admission.52 cases underwent incision and drainage,14 cases received simple anti- infection treatment.1 patients received tracheostomy,There were two deaths shortly after hospital discharge,all had an underlying severe systemic disease.The remaining patients received satisfactory treatment effect. Conclusion Better clinical results and lower mortality can be achieved by cooperative management including systematic and local treatment, MSI should be taken to intravenous rational antibiotics therapy.Surgical intervention involved abscess incision and drainage for abscess formation cases should be required early, and actively controlled complications, in order to improve the cure rate after once diagnosed.