口腔颌面部狗咬伤患者一期缝合与延期缝合的疗效比较

发布时间：2017-12-27 02:08

  本文关键词：口腔颌面部狗咬伤患者一期缝合与延期缝合的疗效比较　出处：《吉林大学学报(医学版)》2016年06期 　论文类型：期刊论文

  更多相关文章： 狗咬伤 一期缝合 延期缝合

【摘要】：目的:比较口腔颌面部狗咬伤患者行一期缝合与延期缝合治疗的效果,探讨一期缝合的可行性。方法:收集31例颌面部狗咬伤患者的临床资料,按照缝合方式分为一期缝合组(20例)和延期缝合组(11例)。一期缝合组患者伤口周围常规肥皂水冲洗,消毒皮肤,局部浸润麻醉,彻底清创,庆大霉素与甲硝唑交替冲洗,转移皮瓣,缝合伤口,术后应用抗生素并及时接种狂犬疫苗和破伤风疫苗。延期缝合组患者伤口周围常规肥皂水冲洗,消毒皮肤,局部浸润麻醉,彻底清创,庆大霉素与甲硝唑交替冲洗,无菌纱布覆盖创面,定期更换敷料,伤口延期缝合,术后常规注射狂犬疫苗和破伤风疫苗,全身应用抗生素。比较2组患者伤口感染率和温哥华瘢痕评定量表(VSS)评分。结果:一期缝合组20例患者中,有2例(10.00%)出现不同程度的伤口感染,无全身性感染出现,均未发生狂犬病及破伤风;延期缝合组11例患者中,有2例(9.09%)出现不同程度的伤口感染,无全身性感染出现,均未发生狂犬病及破伤风。2组患者伤口感染率比较差异无统计学意义(P0.05)。一期缝合组患者VSS评分(Z=257)高于延期缝合组(Z=239),组间比较差异有统计学意义(P0.05)。结论:一期缝合患者伤口感染率与延期缝合相近,但一期缝合的伤口比延期缝合更美观,适用于口腔颌面部狗咬伤患者。
[Abstract]:Objective: To compare the effect of one-stage suture and delayed suture for patients with oral and maxillofacial bites, and to explore the feasibility of primary suture. Methods: the clinical data of 31 cases of maxillofacial dog bites were collected and divided into one stage suture group (20 cases) and delayed suture group (11 cases) according to the suture method. Patients in the primary suture group were washed with conventional soap solution, sterilized skin, local infiltration anesthesia, thorough debridement, gentamicin and metronidazole alternately rinsed, transferred skin flap, suture wounds, postoperative antibiotics were applied, and rabies vaccine and tetanus vaccine were vaccinated in time. Delayed suture group were wound around the regular soap and water, skin disinfection, local anesthesia, debridement, gentamicin and metronidazole douche, sterile gauze to cover the wound and change dressing regularly, delayed suture of wound, postoperative routine injection of rabies vaccine and tetanus vaccine wind, systemic antibiotics. The rate of wound infection and the scale of Vancouver scar assessment scale (VSS) were compared between the 2 groups. Results: a suture group of 20 patients, 2 cases (10%) with varying degrees of wound infection, no systemic infection occurred, rabies and tetanus; delayed suture group of 11 patients, 2 cases (9.09%) with varying degrees of wound infection, no systemic infection occurred. There was no rabies and tetanus. There was no significant difference in the rate of wound infection between the 2 groups (P0.05). The VSS score (Z=257) in the primary suture group (Z=239) was higher than that in the delayed suture group (Z=239), and there was a significant difference between the groups (P0.05). Conclusion: the rate of wound infection is similar to that of delayed suture, but the primary wound is more beautiful than the delayed suture. It is suitable for patients with oral and maxillofacial dog bite.
【作者单位】： 吉林大学口腔医院牙体牙髓病科;长春医学高等专科学校口腔教研室;吉林大学口腔医院牙周病科;吉林大学口腔医院口腔颌面外科;
【基金】：吉林省卫计委青年科研项目资助课题(3D514CP23431) 吉林省科技厅自然科学基金资助课题(3D515V663431)
【分类号】：R782.4
【正文快照】： 狗咬伤是口腔颌面部最常见的疾病之一。在与动物有关的伤害中,狗咬伤占60%~80%[1]。城市里狗咬伤的发生率高于农村[2],颌面部狗咬伤通常与整形外科有关[3]。狗咬伤患者在急诊中占1%,但至今对狗咬伤抗菌治疗仍缺少严格的标准,绝大多数情况下是凭借经验治疗,研究[1]显示近20%狗，

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