口腔颌面部新鲜骨折1009例回顾分析

A retrospective study of 1009 patients with oral and maxillofacial fresh trauma

目的 了解口腔颌面部新鲜骨折患者的流行病学特点.方法 收集2008年1月至2013年12月北京大学口腔医学院·口腔医院口腔颌面外科收治的1 009例口腔颌面部新鲜骨折的临床资料,将数据录入SPSS 21.0软件,分析新鲜骨折的高峰年龄、致伤原因、骨折部位、致伤时间的特点.结果 1 009例新鲜骨折中男：女为2.94：1,20～29岁（338例,33.5％）为高峰年龄,致伤原因以交通伤居首位（424例,42.0％）,其次是摔伤（250例,24.8％）和暴力伤（128例,12.7％）.2008至2013年新鲜骨折病例数逐渐增加,各种致伤原因的患者在20～29岁均达到高峰,因年代、月份不同呈现时间规律性变化.骨折部位以单纯下颌骨骨折居首（536例,53.1％）,其次为颧骨复合体骨折（233例,23.1％）.骨折合并神经损伤中,眶下神经受累最多（144例）;合并全身损伤中,四肢损伤最多见（77例）,其次为胸部（65例）和颅脑（57例）损伤;交通事故引发的全身合并伤最多（127处）,其次为高坠伤（32处）.Logistic回归分析表明高坠伤、摔伤是下颌骨、髁突骨折共同的危险因素（OR＞1,P＜0.05）,年龄是二者的保护因素（OR＜1,P＜0.05）.结论 口腔颌面部新鲜骨折以青年人最多见,交通伤为主要致伤原因,致伤原因呈规律性变化.眶下神经常受累,合并损伤中四肢损伤最常见,治疗时应注意检查眶下区及四肢.交通伤患者应注意检查有无全身合并伤,高坠伤、摔伤患者应特别注意下颌骨及髁突有无骨折.

Objective To analyze the epidemiological characters of fresh maxillofacial fractures in hospitalized patients by the retrospective study.Methods From Jan.2008 to Dec.2013, a total of 1 009 patients with fresh maxillofacial fractures treated at Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology were investigated.The data were statistically analyzed by SPSS 21.0.Results The male and female ratio was 2.94：1 and 33.5% of the patients aged from 20 to 30 years.The most common cause of the fresh fracture was road traffic accidents（424 cases, 42.0%）, followed by tumblings（250 cases, 24.8%） and violence（128 cases, 12.7%）.The number of new fracture was increasing gradually in recent years.The patients were at peak of 20-29 years old.The mandibular fracture was the most frequently seen（536 cases, 53.1%）, followed by zygomatic complex fractures（233 cases, 23.1%）.The simple maxillary fracture was rare and usually combined with other fractures.Infraorbital nerve injury was the most common one in nerve injuries（144 cases）.The most common associated injury was extremity injuries （77 cases）, followed by thoracic injury（65 cases） and craniocerebral injury（57 cases）.Associated injuries were mostly caused by car accidents（127 sites）, followed by fall（32 sites）.Logictic regression analysis showed that fall and tumbling were risk factors of mandibular and condylar fracture （OR〉1, P〈0.05）, while age was a protective factor（OR〉1, P〈0.05）.Conclusions Oral and maxillofacial fresh fractures most commonly occurred in young people, and the most common cause of fractures was road traffic accidents.Infraorbital nerve was involved frequently.The most common associated injuries was extremity injuries.