96例重症颌面部外伤的早期观察与治疗体会.docVIP

96例重症颌面部外伤的早期观察与治疗体会 【摘要】 目的 探讨重症颌面部外伤的早期观察的临床征象以及治疗体会， 为重症颌面部外伤患者的治疗提供依据。方法 96例重症颌面部外伤患者， 分别对其外伤分布情况、发病情况、致病原因以及颌面部外伤的早期观察情况等进行回顾性分析。结果 96例重症颌面部外伤患者中， 面部深部组织挫伤42例、头面部骨折23例、颅底骨折13例、其他18例；损伤原因有：交通意外34例、机械性损伤31例、高空坠落伤25例、其他原因6例；不同部位的损伤其早期伴随的症状和体征有所差异， 伴有颌面部的骨骼、神经、血管、颅脑损伤时， 则可出现出血、窒息、休克、感染、颅脑损伤症状；96例患者经积极治疗后， 治愈94例， 治愈率达97.92%， 死亡2例， 死亡率2.08%。结论 重症颌面部外伤因部位特殊， 处理较为困难， 临床医师需要严格观察患者的早期症状， 避免诊断的片面性， 提高诊断及治疗的准确率， 尽量减少相关后遗症和死亡病例的发生。 【关键词】 重症颌面部外伤；早期观察；治疗体会；后遗症 DOI：10.14163/j.cnki.11-5547/r.2015.17.015 Early observation and treatment experience of 96 severe maxillofacial injuries cases TANG Sheng-bin， LI Yu-feng. Department of Stomatology， Hunan Changsha City the Fourth Hospital， Changsha 410006， China 【Abstract】 Objective To investigate clinical signs of early observation and treatment experience of severe maxillofacial injuries， in order to provide reference for treatment of severe maxillofacial injuries patients. Methods There were 96 patients with severe maxillofacial injuries. Their injury position， morbidity， nosogenesis， and early observation were retrospectively analyzed. Results In the 96 patients with severe maxillofacial injuries， there were 42 cases with facial deep tissue contusion， 23 cases with head and facial fracture， 13 cases with basilar skull fracture， 18 cases with other injuries. Injury causes included 34 cases of traffic accident， 31 cases of mechanical injury， 25 cases of falling injury， and 6 cases of other causes. Different injuries included different early symptoms and physical signs. Maxillofacial injuries in bone， nerve， blood vessel， and craniocerebral injury might lead to hemorrhage， asphyxia， shock， infection， and craniocerebral injury symptoms. After receiving active treatment， 94 cases among the 96 patients were cured， with the cure rate as 97.92%， and there were 2 death cases， with the mortality rate as 2.08%. Conclusion Severe maxillofacial injuries are difficult for managing， due to the special injury positions. Clinicians should have stri