糖尿病与非糖尿病口腔颌面部间隙感染患者临床特征分析

Analysis of the clinical features of an orofacial space infection in patients with diabetes and non-diabetics

目的糖尿病与非糖尿病口腔颌面部间隙感染患者临床特征分析,为临床疾病治疗提供指导。方法收集57例糖尿病口腔颌面部间隙感染患者和71例非糖尿病口腔颌面部间隙感染患者临床资料,鉴定患者感染病原菌,检测患者临床指标。结果糖尿病与非糖尿病口腔颌面部间隙感染患者性别、病因差异不显著,但年龄差异显著;糖尿病口腔颌面部间隙患者感染的链球菌属、葡萄球菌属、肺炎克雷伯菌、厌氧菌、肠杆菌属及其他病原菌分别为9、7、12、5、4和2株,非糖尿病组分别为17、10、7、6、2和1株;糖尿病组感染患者血糖水平(12.37±3.85)mmol/L,非糖尿病组为(5.51±0.46)mmol/L,差异有统计学意义(t=13.340,P=0.000);白细胞计数水平糖尿病组为(16 674.64±2 239.84)mm3,非糖尿病组为(16 378.54±837.47)mm3,差异无统计学意义(t=0.718,P=0.475);中性粒细胞百分比水平糖尿病组为(79.98±10.50)%,非糖尿病组为(78.08±11.67)%,差异无统计学意义(t=0.689,P=0.494)。糖尿病组患者呼吸道梗阻、纵膈炎、脓毒症、肺炎、颅内感染、中毒性休克、皮肤缺损的并发症发生率分别为10.53%、5.26%、3.51%、3.51%、3.51%、5.26%和5.26%;非糖尿病组分别为7.04%、2.82%、2.82%、4.23%、2.82%、0和0。结论糖尿病患者口腔颌面部间隙感染病原菌以肺炎克雷伯菌为主,非糖尿病组以链球菌属为主。两组患者并发症主要为呼吸道梗阻。患者发生口腔颌面部间隙感染时,白细胞计数及中性粒细胞百分比水平升高,对临床诊断有指导价值。

Objective To analyze the clinical features of an orofacial space infection in patients with diabetes and non-diabetics in order to guide the clinical treatment of that infection. Methods Clinical data on 57 patients with diabetes and an orofacial space infection and 71 patients without diabetes and with an orofacial space infection were collected to identify the pathogenic bacteria infecting patients and determine clinical indices in patients. Results Patients with diabetes and non-diabetics did not differ significantly in terms of sex or the cause of an orofaeial space infection, but they did differ significantly in terms of age. In patients with diabetes, an orofacial space infection was caused by 9 strains of Strep- tococcus, 7 strains of Staphylococcus, 12 strains of Klebsiella pneumoniae, 5 strains of anaerobic bacteria, 4 strains of Enterobacteria, and 2 strains of other pathogens. In non-diabetics, an orofacial space infection was caused by 17 strains of Streptococcus, 10 strains of Staphylococcus, 7 strains of Klebsiella pneumoniae, 6 strains of anaerobic bacteria, 2 strains of Enterobacteria, and 1 strain of some other pathogen. The blood glucose level was 12.37±3.85 mmol/L in infected pa- tients with diabetes and 5.51±0.46 mmol/L in non-diabetics, and the level did not differ significantly （t= 13. 340; P=0. 000）. The white blood cell count was 16 674.64±2239.84 mm^3 in patients with diabetes and 16 378.54±837.47 ram5 in non-diabetics, and the cell count differed significantly （t=0. 718, P=0.475）. The percentage of neutrophils was 79. 98±10.50% in patients with diabetes and 78.08±11.67% in non-diabetics, and percentage of neutrophils did not differ significantly （t=0. 689, P=0. 494）. Ten-point-five-three percent of patients with diabetes had a complication in the form of a respiratory obstruction, 5.26% had mediastinal inflammation, 3.51% had sepsis, 3.51% had pneumonia, 3.51% had an intracranial infection, 5.26% had toxic shock, and 5.26% had a skin defect. Seven-point-zero-four percent of non- diabetics had a complication in the form of a respiratory obstruction, 2. 82% had mediastinal inflammation, 2.82% had sepsis, 4.23% had pneumonia, 2.82% had an intracranial infection, 0% had toxic shock, and 0% had a skin defect.Conclusion The main pathogenic bacteria causing an orofacial space infection was K. pneumoniae in patients with diabetes and .Streptococcus in non-diabetics. The main complication in the 2 groups of patients was a respiratory obstruction. The white blood cell count and percentage of neutrophils increased when patients developed an orofaeial space infection, so these features can guide the clinical diagnosis of an orofacial space infection.