老年口腔颌面颈部多间隙感染的诊治分析

Diagnosis and treatment of oral maxillofacial and neck multi space infection in the elderly

目的:探讨老年患者口腔颌面颈部多间隙感染的特点及治疗方法。方法:对116例老年患者口腔颌面颈部多间隙感染的临床表现、感染部位、病因学、细菌学、系统性疾病及并发症进行分析,并进行以早期充分切开引流为主的综合治疗,评价治疗效果。结果:最常累及的间隙为颌下、颏下、舌下、翼颌、咬肌及咽旁间隙。最常见的病因为牙源性感染。革兰氏阳性需氧菌感染多见。大部分患者合并有全身系统性疾病。所有患者均达到治愈,无严重并发症,无死亡病例。结论:对老年口腔颌面颈部多间隙感染患者,应安排急诊入院,尽快完善相关检查,以关注全身情况为基础,及早急诊充分切开引流为主,进行多学科多手段的综合治疗,可取得良好效果。

Objective:To investigate the clinical features and treatment experience of oral,maxillofacial and neck multi-space infection in the elderly.Methods:Clinical manifestations,infection sites,etiology,bacteriology,systemic diseases and complications of 116 elderly patients with multi-space infection of oral and maxillofacial and neck were analyzed All patients were performed as early as surgical drainage and appropriate antibiotics and comprehensive treatments.Follow-up was carried out to observe the treatment result.Results:The most commonly involved spaces were submandibular spaces,submental spaces,sublingual spaces,pterygomaxillary spaces,masseter spaces and parapharyngeal spaces.The most common pathogeny was odontogenic infection.Gram positive aerobic bacteria infection was common.Most patients had systemic diseases.All patients were curing,no severe complication and there were no deaths.Conclusion:For elderly patients with multi-space infection of oral and maxillofacial and neck,emergency admission should be arranged and relevant examinations should be improved as soon as possible.Based on paying attention to the systemic situation,early emergency adequate incision and drainage should be given priority to,and multi-disciplinary and multi-means comprehensive treatment can achieve good results.