患者口腔颌面部间隙感染因素分析

发布时间：2018-07-10 05:39

  本文选题：口腔颌面部间隙感染 + 病原菌　； 参考：《中华医院感染学杂志》2017年04期

【摘要】：目的探讨患者口腔颌面部间隙感染(MSI)的感染来源、并发症发生及危险因素,为临床MSI感染的诊治提供依据。方法选择2014年1月-2015年12月医院口腔科MSI患者120例为研究对象,收集患者的临床资料。结果 120例患者MSI的感染来源包括牙源性感染67例(55.8%)和非牙源性感染53例(44.2%),其中牙源性感染包括根尖周炎27例(22.5%),智牙冠周炎23例(19.2%),牙周病16例(13.3%),其他1例(0.8%);非牙源性感染包括腺源性感染16例(13.3%),非特异性淋巴结炎14例(11.7%),皮肤感染13例(10.8%),骨髓炎6例(5.0%),其他4例(3.3%);65例病原菌培养结果阳性,45例培养结果为单一致病菌,20例培养结果为混合感染,共培养菌株85株,主要病原菌为肺炎克雷伯菌24株占28.2%、酿脓链球菌19株占22.4%、金黄色葡萄球菌19株占22.4%和厌氧菌18株占21.2%;120例患者中18例患者出现并发症,其中12例出现呼吸困难,3例出现肺炎,2例出现胸腔积液,1例出现呼吸衰竭;单因素分析结果发现,糖尿病、白细胞计数≥15×109/L、多间隙感染者并发症的发生率(24.4%、26.3%、39.1%)高于无糖尿病、白细胞计数15×109/L、单间隙感染者(10.1%、9.8%、9.3%),差异有统计学意义(P0.05);多因素分析结果发现,白细胞计数≥15×109/L和多间隙感染是发生并发症的独立危险因素,差异有统计学意义(P0.05)。结论 MSI主要来源于牙源性感染,主要病原菌为酿脓链球菌和肺炎克雷伯菌,白细胞计数≥15×109/L和多间隙感染是发生MSI并发症的独立危险因素。
[Abstract]:Objective to investigate the origin, complications and risk factors of oral and maxillofacial space infection (MSI) in order to provide evidence for the diagnosis and treatment of MSI infection. Methods 120 MSI patients from January 2014 to December 2015 were selected and their clinical data were collected. Results the sources of MSI infection in 120 patients included odontogenic infection in 67 cases (55.8%) and non-odontogenic infection in 53 cases (44.2%), including periodontitis in 27 cases (22.5%), pericoronitis in 23 cases (19.2%), periodontal disease in 16 cases (13.3%), non-dental infection in 1 case (0.8%), odontogenic infection in 27 cases (22.5%), periodontal periodontitis in 23 cases (19.2%), periodontal disease in 16 cases (13.3%), and other cases in 0.8%. There were 16 cases of adenogenic infection (13.3%), 14 cases of nonspecific lymphadenitis (11.7%), 13 cases of skin infection (10.8%), 6 cases of osteomyelitis (5.0%), and 4 cases (3.3%) of the other 65 cases (3.3%). The main pathogens were Klebsiella pneumoniae (24 strains), Streptococcus pyogenes (19 strains), Staphylococcus aureus (22.4%) and anaerobic bacteria (18 strains). Among them, 12 cases had dyspnea, 3 cases had pneumonia and 2 cases had pleural effusion and 1 case had respiratory failure. Univariate analysis showed that the incidence of complications in diabetes mellitus, leukocyte count 鈮，

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