口腔颌面部间隙感染的诊断及治疗效果评价

Diagnosis of oral and maxillofacial clearance infections and treatment experience

目的探讨口腔颌面部间隙感染的临床诊断和治疗方法,以期提高预防、诊断和治疗水平。方法回顾性分析2007年1月-2012年1月收治的58例口腔颌面部感染患者临床资料,对其感染部位、感染源、细菌培养结果、彩色多普勒超声、CT、MRI表现以及治疗方法进行综合分析,并评价其治疗效果。结果 58例患者感染部位以颌下间隙和眶下间隙最为多见,分别占36.21%、15.52%;感染来源以牙源性感染为居多,共35例占60.34%;影像学检查结果23例脓肿和35例蜂窝组织炎;细菌培养检出金黄色葡萄球菌最高,占22.41%,其对抗菌药物均敏感;经治疗痊愈50例,好转7例,总有效率达98.27%,出现并发症2例,分别是并发败血症和并发边缘性骨髓炎,经积极治疗痊愈。结论口腔颌面间隙感染应结合各种辅助诊断方法快速、准确作出诊断,采用全身治疗和局部治疗相结合的治疗方法,积极给予有效抗菌药物、对症、控制感染等处理,局部形成脓肿时应及时切开引流,促进患者早日康复,从而提高患者的生活质量。

OBJECTIVE To explore the clinical diagnosis and treatment of oral and maxillofacial space infections so as to improve the prevention,diagnosis and treatment level.METHODS The clinical data of 58 patients with oral and maxillofacial infections who were treated in the hospital from Jan 2007 to Jan 2012 were retrospectively analyzed.The infection site,the source of infection and bacterial culture results,color doppler ultrasound,CT and MRI performance and treatment were comprehensively analyzed,and the therapeutic effect was evaluated.RESULTS Of 58 patients investigated,the patients with submandibular space infections accounted for 36.21%,the patients with Infraorbital gap infections 15.52%;there were 35（60.34%） cases of patients with tooth source infections,which was the majority.The radiographic inspection showed that there were 23 cases with abscess and 35 cases with cellulites.Of the bacteria cultured,Staphylococcus aureus was dominant,accounting for 22.41%,and all the strains were sensitive to antibiotics.After the treatment,50 cases were cured,7 cases improved,with the total effective rate of 98.27%;there were two cases with complications which were the sepsis and concurrent marginality osteomyelitis,and the two cases were cured after active treatment.CONCLUSION Oral cavity jaw face space infections should be accurately and rapidly diagnosed based on all kinds of auxiliary diagnosis methods,the systemic treatment combined with local treatment is adopted,the sensitive antibiotics should be given symptomatically to control the infections,and the local abscess should be incised for drainage in a timely manner so as to promote the recovery and improve the quality of life.