糖尿病患者口腔颌面部多间隙感染的临床诊治研究

发布时间：2019-07-09 17:48

【摘要】：目的回顾总结糖尿病患者口腔颌面部多间隙感染的临床特点和治疗经验。方法对22例患者的基本信息、感染来源、实验室结果、气道护理、切口的选择、引流方式、治疗效果等进行总结和回顾性分析。结果 68.2%患者为牙源性感染,脓液培养以肺炎克雷伯菌和链球菌属为主;36.4%患者入院时出现呼吸困难症状。22例患者入院后根据经验选择抗生素静脉给药,待细菌培养+药敏试验结果返回后,调整给药;控制血糖;脓肿及早切开,5例患者行负压封闭引流术;局部+全身对症支持治疗;21例痊愈,1例死亡。结论伴有糖尿病的口腔颌面部多间隙感染患者治疗的关键在于做好气道管理,脓肿及早切开,合理应用抗生素,有效降血糖等,综合运用改良手术切口和负压封闭引流技术,能提高治愈率。
[Abstract]:Objective to review and summarize the clinical characteristics and treatment experience of oral and maxillofacial multiple space infection in diabetic patients. Methods the basic information, infection source, laboratory results, airway nursing, incision selection, drainage method and therapeutic effect of 22 patients were summarized and analyzed retrospectively. the results showed that the basic information, infection source, laboratory results, airway nursing, incision selection, drainage method and therapeutic effect were analyzed retrospectively. Results 68.2% of the patients were odontogenic infection, Klebsiella pneumoniae and Streptococcus pneumoniae were dominant in pus culture, 36.4% patients had dyspnea symptoms on admission. 22 patients were treated with antibiotics according to experience, and the drug administration was adjusted when the results of bacterial culture drug sensitivity test returned, blood glucose control, abscess incision as early as possible, negative pressure closed drainage in 5 patients, local systemic symptomatic support treatment. 21 cases were cured and 1 case died. Conclusion the key to the treatment of oral and maxillofacial multi-space infection with diabetes mellitus lies in airway management, early incision of abscess, rational use of antibiotics, effective hypoglycemia, comprehensive application of improved surgical incision and negative pressure closed drainage technique, which can improve the cure rate.
【作者单位】：西南医科大学附属口腔医院口腔颌面外科;西南医科大学口颌面修复重建和再生实验室;
【基金】：四川省科技厅项目(2014JY0044)
【分类号】：R782.3;R587.1

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