基于Dodson法对中国西南地区儿童颌面部间隙感染的临床特点和治疗方法的比较研究

发布时间：2019-01-23 14:07

【摘要】：目的:探讨不同解剖区域儿童颌面部间隙感染的临床特征和治疗方法,为今后行有针对性的治疗提供参考。材料和方法:本研究系回顾性研究。1.回顾性分析重庆医科大学附属儿童医院口腔科2009年1月至2014年12月收治的44例颌面部间隙感染住院患儿临床资料。44例患儿符合以下标准:1.出、入院主要诊断符合ICD-10编码中颌面部各间隙感染诊断。2.所有病历均有详细的临床病史、治疗记录及随访结果等临床资料。2.依据颌面部各间隙解剖区域不同,运用Dodson分类法以牙合平面将颌面部分为面上份组和面下份组。对44例患儿的基本信息、感染累及的间隙部位以及感染源、入院前是否存在不规范用药、入院前全身症状、入院前局部症状持续时间、入院时体温及白细胞计数、入院后是否接受手术治疗及住院时间等进行统计学分析,比较两组患儿的临床特征和治疗方法,探讨其是否存在差异。结果:1.面上份感染组和面下份感染组的发病平均年龄分别为(2.76±2.42)和(5.11±3.69)岁,面上份感染组发病年龄显著低于面下份感染组(P=0.035)。2.入院前局部症状持续时间面上份感染组和面下份感染组分别为(3.38±1.82)和(7.61±4.52)天,入院前局部症状持续时间面上份感染组明显较面下份感染组短(P=0.001)。3.面上份感染组患儿最常见感染源为损伤源性(56.25%),其次为牙源性(31.25%)和腺源性(12.5%);面下份感染组最常见感染源为腺源性(57.14%),其次为牙源性(32.14%)和损伤源性(7.14%);面上份组损伤源性感染率显著高于面下份组,而面下份感染组腺源性感染率显著高于面上份组(P=0.000)。4.面上份组中颊间隙感染最常见(68.75%),面下份感染组中最常见的是颌下间隙感染(35.72%)和咬肌间隙感染(28.57%)。5.面上份感染中保守治疗率62.5%,手术治疗率37.5%。面下份感染保守治疗率14.29%,手术治疗率85.71%。面上份感染组选择保守治疗方法显著高于面下份感染组,而选择手术治疗方法较面下份感染组显著减少(P=0.001)。两组患儿经治疗后总有效率97.7%。两组治疗疗效无显著性差异。6.两组患儿性别比例、入院前不规范用药、入院时全身症状及体温、白细胞计数等均无显著差异。结论:不同解剖区域的颌面部间隙感染其发病年龄、感染部位及来源、治疗方法等均存在差异。
[Abstract]:Objective: to explore the clinical features and treatment of maxillofacial space infection in children in different anatomical regions, and to provide reference for future targeted treatment. Materials and methods: this study is a retrospective study. 1. The clinical data of 44 hospitalized children with maxillofacial space infection from January 2009 to December 2014 in Department of Stomatology, affiliated Children's Hospital of Chongqing Medical University were analyzed retrospectively. 44 cases met the following criteria: 1. The main diagnosis of admission accords with the diagnosis of maxillofacial infection in the middle and middle maxillofacial region coded by ICD-10. 2. 2. All cases have detailed clinical history, treatment records and follow-up results. 2. According to the different anatomical regions of the maxillofacial space, the maxillofacial region was divided into upper facial group and subfacial group by Dodson classification. The basic information of 44 children, the space of infection and the source of infection, whether there were any nonstandard medication before admission, systemic symptoms before admission, duration of local symptoms before admission, body temperature and white blood cell count at admission, were analyzed in 44 cases. The clinical characteristics and treatment methods of the two groups were compared and the differences were discussed. Results: 1. The mean age of the upper and lower facial infection groups were (2.76 卤2.42) and (5.11 卤3.69) years, respectively. The onset age of the upper facial infection group was significantly lower than that of the subfacial infection group (P0. 035). The duration of local symptoms before admission was (3.38 卤1.82) and (7.61 卤4.52) days, respectively. The duration of local symptoms before admission was significantly shorter in the suprafacial infection group than in the subfacial infection group (P < 0.001). The most common source of infection was injury (56.25%), odontogenic (31.25%) and glandular (12.5%). The most common source of infection was adenogenic (57.14%), odontogenic (32.14%) and injury (7.14%). The infection rate of injury in the upper group was significantly higher than that in the subfacial group, while the infection rate in the subfacial group was significantly higher than that in the upper group (P0. 000). In the suprafacial group, buccal space infection was the most common (68.75%), submaxillary space infection (35.72%) and masseter space infection (28.57%) were the most common in the subfacial infection group. The conservative treatment rate was 62.5% and the operative treatment rate was 37.5%. The conservative treatment rate of subfacial infection was 14.29 and the operative treatment rate was 85.71. The choice of conservative treatment was significantly higher in the suprafacial infection group than in the subfacial infection group, while the choice of surgical treatment was significantly lower than that in the subfacial infection group (P0. 001). The total effective rate of the two groups after treatment was 97. 7%. There was no significant difference in therapeutic effect between the two groups. 6. 6. There was no significant difference between the two groups in sex ratio, abnormal medication before admission, systemic symptoms, body temperature and white blood cell count. Conclusion: there are differences in age, location, source and treatment of maxillofacial space infection in different anatomical regions.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.3

【参考文献】