封闭负压引流治疗严重的口腔颌面部间隙感染的临床分析

Clinical Analysis of Vacuum Sealing Drainage in Treatment of Severe Oral and Maxillofacial Space Infection

目的:回顾性分析严重的口腔颌面部间隙感染患者的临床特点、治疗方法及治疗效果,探究合适的治疗策略。方法:回顾性分析2011年11月~2018年4月在我院颌面外科收治的咽旁间隙感染和纵隔感染患者共18例。其中男12例,女6例。年龄16~75岁,中位数年龄为54岁,应用封闭负压引流持续治疗。结果:重度口腔颌面部间隙感染患者12例,极重度口腔颌面部间隙感染患者6例,17例患者共有62个并发症,8例患者伴有系统性疾病,脓肿在入院后中位数6.125 h切开,植入封闭负压引流,多学科联合治疗,早期经验性抗生素对症支持治疗后,所有患者均好转,无死亡病例。结论:严重的口腔颌面部间隙感染须准确诊断,早期切开,多学科支持联合治疗,封闭负压引流植入后脓液引流效果好。

Objective:To analyze the clinical parameters,treatment method,and treatment effects in patients with severe and profound oral and maxillofacial space infections.Methods:Clinical characteristics of eighteen patients with severe oral and maxillofacial space infections were collected from Nov.2011 to Apr.2018.Twelve patients were male and six were female,from 16 to 75 years old and the median age was 54 years old.All patients were underwent surgical and vacuum sealing drainage therapy.Results:Twelve patients were diagnosed with severe oral and maxillofacial space infections and six patients were diagnosed with profound oral and maxillofacial space infections.Sixty-two complications were developed in 17 patients,and eight out of eighteen patients had underlying systemic disease like diabetes mellitus,hypertension,hepatitis,and etc.Patients were underwent surgical intervention at the median of 6.125 hours after admission.All patients were survived.Conclusion:Accurate diagnosis,aggressive management,vacuum sealing drainage,and multidisciplinary assistance are all necessary for treating severe oral and maxillofacial space infection.