3050例颌面部损伤临床分析

Retrospective analysis of 3050 patients with maxillofacial trauma

目的分析3050例颌面部损伤的临床表现及治疗效果，为颌面部损伤综合治疗方案的确定提供数据资料。方法选择因颌面部损伤住院的3050例患者的临床资料进行回顾，分析患者的性别、年龄、损伤原因、职业、地域分布、血型、骨折部位、合并伤、首诊收入科室及治疗效果等因素。结果3050例颌面部损伤患者中，男女比例为3.9∶1；20～40岁（1711例，56.1%）为发病的高峰年龄；交通事故伤（1055例，34.6%）在致伤原因中居首位；颧骨复合体（707例，23.2%）、鼻眶筛骨（650例，21.3%）、下颌骨（540例，17.7%）在颌面部骨折中居前三位。颌面部损伤常合并颅脑损伤（1321例，43.3%）及面部软组织挫裂伤（1275例，41.8%）。2632例骨折患者中，首诊收入科室包括口腔科（67.3%）、骨科（11.6%）及脑外科（8.4%）。所有患者的简明损伤评分（abbrebiatedinjuryscale，AIS）平均得分为2.3分，介于中度与较重度之间。手术治疗1694例（55.5%），保守治疗1356例（44.5%）。结论颌面部损伤患者中以男性为主，以青壮年比例最高；交通事故伤为主要致伤原因；颧骨复合体、鼻眶筛骨及下颌骨最容易发生骨折；颌面部损伤常合并颅脑、胸腹腔、四肢等其他重要部位损伤；颌面部损伤的治疗效果总体满意。

Objective To review the clinical data of 3 050 patients with maxillofacial trauma in order to provideguidance for clinical diagnosis and treatment. Methods During January 2010 to December 2014, 3 050 maxillofacialtraumatic patients were selected in Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Tradition?al Chinese Medicine in this retrospective analysis regarding data of sex, age, causes of injury, occupation, geographicdistribution, blood type, fracture site, multiple associated injuries, first admitted department, treatment result were re?viewed. Results The male and female ratio was 3.9∶1.1. 711 cases (56.1%) were between 20 to 40 years old. The traf?fic accident (1 055 cases, 34.6%) was the first traumatic cause. The zygomatic complex (707 cases, 23.2%), naso?orbital?ethmoid (650 cases, 21.3%), mandible (540 cases, 17.7%) were most vulnerable. Maxillofacial injury was often associat?ed with brain injury (1 321 cases, 43.3%) and facial soft tissue contusion (1 275 cases, 41.8%). For the 2 632 maxillofa?cial fracture patients, the first admitted department included stomatology department (67.3%), orthopaedics (11.6%),brain surgery (8.4%), et al. The average score of AIS was 2.3 which was between moderate and severe. The treatment in?cluded operation treatment (1694 cases, 55.5%), and conservative treatment (1 356 cases, 44.5%). Conclusion Maletook the majority part of injury for the maxillofacial traumatic patients. The 20 to 40 year old people occupated the highest proportion. Traffic accident was the first cause of injury meanwhile the fall injury proportion rose. Zygomatic com?plex, naso?orbital?ethmoid, mandible fracture were the most vulnerable injuries. Maxillofacial injury often combinedwith brain, chest, abdomen and other important organs. The patients were adimtted to the appropriate department ac?cording to the injury. The overall treatment effect was satisfied.