【摘要】：目的:探討不同解剖區(qū)域兒童頜面部間隙感染的臨床特征和治療方法,為今后行有針對(duì)性的治療提供參考。材料和方法:本研究系回顧性研究。1.回顧性分析重慶醫(yī)科大學(xué)附屬兒童醫(yī)院口腔科2009年1月至2014年12月收治的44例頜面部間隙感染住院患兒臨床資料。44例患兒符合以下標(biāo)準(zhǔn):1.出、入院主要診斷符合ICD-10編碼中頜面部各間隙感染診斷。2.所有病歷均有詳細(xì)的臨床病史、治療記錄及隨訪結(jié)果等臨床資料。2.依據(jù)頜面部各間隙解剖區(qū)域不同,運(yùn)用Dodson分類法以牙合平面將頜面部分為面上份組和面下份組。對(duì)44例患兒的基本信息、感染累及的間隙部位以及感染源、入院前是否存在不規(guī)范用藥、入院前全身癥狀、入院前局部癥狀持續(xù)時(shí)間、入院時(shí)體溫及白細(xì)胞計(jì)數(shù)、入院后是否接受手術(shù)治療及住院時(shí)間等進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩組患兒的臨床特征和治療方法,探討其是否存在差異。結(jié)果:1.面上份感染組和面下份感染組的發(fā)病平均年齡分別為(2.76±2.42)和(5.11±3.69)歲,面上份感染組發(fā)病年齡顯著低于面下份感染組(P=0.035)。2.入院前局部癥狀持續(xù)時(shí)間面上份感染組和面下份感染組分別為(3.38±1.82)和(7.61±4.52)天,入院前局部癥狀持續(xù)時(shí)間面上份感染組明顯較面下份感染組短(P=0.001)。3.面上份感染組患兒最常見(jiàn)感染源為損傷源性(56.25%),其次為牙源性(31.25%)和腺源性(12.5%);面下份感染組最常見(jiàn)感染源為腺源性(57.14%),其次為牙源性(32.14%)和損傷源性(7.14%);面上份組損傷源性感染率顯著高于面下份組,而面下份感染組腺源性感染率顯著高于面上份組(P=0.000)。4.面上份組中頰間隙感染最常見(jiàn)(68.75%),面下份感染組中最常見(jiàn)的是頜下間隙感染(35.72%)和咬肌間隙感染(28.57%)。5.面上份感染中保守治療率62.5%,手術(shù)治療率37.5%。面下份感染保守治療率14.29%,手術(shù)治療率85.71%。面上份感染組選擇保守治療方法顯著高于面下份感染組,而選擇手術(shù)治療方法較面下份感染組顯著減少(P=0.001)。兩組患兒經(jīng)治療后總有效率97.7%。兩組治療療效無(wú)顯著性差異。6.兩組患兒性別比例、入院前不規(guī)范用藥、入院時(shí)全身癥狀及體溫、白細(xì)胞計(jì)數(shù)等均無(wú)顯著差異。結(jié)論:不同解剖區(qū)域的頜面部間隙感染其發(fā)病年齡、感染部位及來(lái)源、治療方法等均存在差異。
[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 鹵2.42) and (5.11 鹵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 鹵1.82) and (7.61 鹵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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.3

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