口腔急诊颌面部感染患者临床分析

Clinical analysis of patients with oral and maxillofacial infections in oral emergency

目的:分析口腔急诊颌面部感染的病种构成、发病情况及临床特点,以指导口腔急诊颌面部感染的临床诊疗和预防。方法:回顾性分析2017年1月至2019年12月期间就诊于北京大学口腔医院急诊科有完整电子病历信息的口腔颌面部感染患者,总结口腔急诊颌面部感染患者的疾病构成、性别、年龄分布、累及牙位等。结果:共纳入口腔颌面部感染患者8277例,其中男性患者4378例(52.9%),女性患者3899例(47.1%),男女比例1.12∶1。口腔急诊科常见颌面部感染疾病依次有牙周脓肿(3826例,46.2%)、牙槽脓肿(3537例,42.7%)、间隙感染(740例,9.0%)、唾液腺炎症(108例,1.3%)、面部疖痈(56例,0.7%)、颌骨骨髓炎(10例,0.1%)。不同疾病好发性别不同:牙周脓肿、间隙感染、面部疖痈好发于男性患者,男女比例分别为1.24∶1、1.26∶1、2.50∶1;牙槽脓肿、唾液腺炎症、面部疖痈发病性别差异不明显,男女比例为0.98∶1、0.96∶1、0.7∶1。口腔颌面部感染高发年龄段为5~9岁、24~67岁。不同疾病好发年龄不同:牙槽脓肿发病高发年龄段为5~9岁、27~67岁;牙周脓肿高发年龄段为30~64岁;间隙感染高发年龄段为21~67岁;唾液腺炎症、面部疖痈、颌骨骨髓炎病例数较少,无明显高发年龄段。在所有口腔颌面部感染患者中,口腔脓肿患者共7363例(牙周脓肿患者3826例,牙槽脓肿患者3537例),占比88.9%,共累及7999颗患牙,其中乳牙717颗,恒牙7282颗。牙周脓肿通常发生于恒牙,其中以上下颌磨牙最易受累;牙槽脓肿在乳牙和恒牙中均有发生,好发于乳磨牙、上颌乳中切牙,以及上下颌第一恒磨牙。结论:了解口腔急诊常见颌面部感染的发病情况,有利于临床疾病的诊断和正确处置,也有助于对不同年龄层和不同性别患者进行有针对性的宣教,预防疾病发生。

Objective:To analyze the composition,incidence and clinical characteristics of oral and maxillofacial infections in oral emergency.Methods:A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted.General characteristics,such as disease composition,gender,age distribution and position of involved teeth were analyzed.Results:A total of 8277 patients with oral and maxillofacial infections were finally collected,including 4378 male patients(52.9%)and 3899 female patients(47.1%),with gender ratio of 1.12∶1.The common diseases were periodontal abscess(3826 cases,46.2%),alveolar abscess(3537 cases,42.7%),maxillofacial space infection(740 cases,9.0%),sialadenitis(108 cases,1.3%),furuncle&carbuncle(56 cases,0.7%)and osteomyelitis(10 cases,0.1%).Male patients were more easily affected by periodontal abscess,space infection and furuncle&carbuncle than female patients with the gender ratios 1.24∶1,1.26∶1,2.50∶1 individually,while the incidence of alveolar abscess,sialadenitis,furuncle&carbuncle had no significant gender difference.Different diseases were prone to occur at different ages.The peak ages of alveolar abscess were 5-9 and 27-67 years,while the peak age of periodontal abscess was 30-64 years.Space infection tended to occur between 21-67 years.There were 7363 patients with oral abscess(3826 patients with periodontal abscess and 3537 patients with alveolar abscess),accounting for 88.9%of all the patients with oral and maxillofacial infections,involving 7999 teeth,including 717 deciduous teeth and 7282 permanent teeth.Periodontal abscess usually occurred in permanent teeth,especially the molar teeth.Alveolar abscess may occur in both primary teeth and permanent teeth.In primary teeth,the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth.Conclusion:Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases,as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.