糖尿病合并口腔颌面部重症间隙感染的临床治疗分析

Analysis of the Clinical Treatment of Diabetes with Oral and Maxillofacial Severe Interstitial Infection

目的对糖尿病合并口腔颌面部重症间隙感染的临床治疗进行分析探讨。方法选取该院于2016年3月—2017年12月期间临床治疗的糖尿病合并口腔颌面部重症间隙感染患者38例,在有效控制血糖水平的前提下,不间断地使用抗生素进行全身对症支持治疗,必要时行切开引流术治疗。回顾患者的临床资料,并对其临床治疗方法及治疗效果进行针对性分析。结果 38例糖尿病合并口腔颌面部重症间隙感染患者均行切开引流术治疗,其中4例实施气管切开术,且有8例送入ICU进行监控,治疗全程均合理控制血糖。患者术后的血糖控制情况为5.63~8.82 mmol/L,共持续治疗15~60 d。其中死亡2例(心跳骤停1例、酮症酸中毒致全身多重要器官衰竭而死亡1例),其余36例(94.74%)患者的口腔颌面部重症间隙感染症状得到良好疗效。结论糖尿病合并口腔颌面部重症间隙感染的类型较多,需严格进行治疗前的综合性评估,以制定出个性化的有效治疗方案,该组患者经临床治疗后均取得了显著疗效。

Objective To analyze the clinical treatment of diabetes with severe interstitial infection of oral and maxillofacial region. Methods 38 cases of patients with diabetes mellitus complicated with severe oral and maxillofacial space infection admitted and treated in our hospital from March 2016 to December 2017 were selected, under the condition of effective control of blood glucose level, the continuous usage of antibiotics for general systematic support treatment should be conducted, if necessary, the incision drainage surgery therapy was conducted, and the clinical data of patients were reviewed, and the clinical treatment method and treatment effect were for targeted analysis. Results All 38 cases were treated with incision drainage surgery, including 4 cases with tracheotomy, 8 cases were submitted to ICU for monitoring, and the blood glucose was rationally controlled in the whole course, after surgery, the blood glucose control situation was 5.63~8.82 mmol/L, and the continuous therapy was 15 to 60 d, including 2 death cases（1 case with cardiac arrest and 1 case with systemic multiple organ failure caused by the ketosis acid）, and the other 36 cases（94.74%） had a good curative effect in the severe interspace infection in oral and maxillofacial region. Conclusion Diabetic patients with oral and maxillofacial severe space infection types are more. The strict general evaluation is needed before treatment, so as to develop personalized and effective treatment plan. This group has achieved notable curative effect after clinical treatment.