浅论穿刺抽脓加闭式冲洗在口腔颌面部脓肿治疗中临床探究.docVIP

浅论穿刺抽脓加闭式冲洗在口腔颌面部脓肿治疗中临床探究 　　【摘要】 目的 比较穿刺抽脓加闭式冲洗与手术切开引流在口腔颌面部脓肿治疗中的效果。方法 采用随机分组的方法，将131例口腔颌面部脓肿患者分为两组，一组采用穿刺抽脓加闭式冲洗进行治疗，对照组采用手术切开引流的传统方法进行治疗。结果 ①穿刺抽脓加闭式冲洗用于颌面部化脓性感染，不但能缓解症状，免除手术的痛苦与恐惧，同时亦无损于患者颌面部美观;②此法即适于颌面部表浅的脓肿，抽脓后冲洗再注入适量抗菌素，疗效佳，病程可缩短。结论 穿刺抽脓加闭式冲洗是口腔颌面部脓肿治疗的有效手段。 　　【关键词】 穿刺抽脓;闭式冲洗;口腔颌面部脓肿 　　 　　【Abstract】 Objective 　　To compare the effect puncture pumping pus and closed washing and surgical incision and drainage in oral and maxillofacial abscess. Methods 131 cases of oral and maxillofacial abscess was divided into two groups, one group was given the puncture pumping pus and closed washing for treatment, control group using surgical incision and drainage of traditional methods of treatment. Results ①Puncture pumping pus and closed washing was used for oral and maxillofacial abscess treatment, not only to alleviate the symptoms, surgery of pain and fear, but also in patients with facial appearance. ②this method was suitable for maxillofacial superficial abscesses, rinse and then after pumping pus into just the right amount of antibiotics, efficacy, the course can be reduced. Conclusion Puncture pumping pus and closed washing is oral and maxillofacial abscess treatment effective means.  　　【Key words】 Puncture pumping pus; Closed washing; Maxillofacial abscess 　　 　　口腔颌面部是人体主要显露部位，一旦受到破坏会影响容貌和功能，会对患者造成一定的生理痛苦和心理负担。而口腔颌面部炎症是口腔颌面外科的常见病、多发病，如未得到及时有效的治疗,往往会由蜂窝织组炎等发展成为局部脓肿。脓肿传统治疗方法是采用手术切开引流,同时服用或注射抗生素,常常会在颌面部遗留瘢痕, 影响到患者的容貌［1］。我科在临床治疗口腔颌面部脓肿治疗过程中采用穿刺抽脓加闭式冲洗的方法，取得了满意的效果。 　　1 资料与方法 　　1.1 一般资料 2005~2010年来我科就诊的颌面部炎症致脓肿病例131例,男71例,女60例,年龄1/2~62岁。其中颌下间隙脓肿53例、颊部皮下较大脓肿45例、嚼肌下间隙脓肿13例、颊间隙脓肿8例、眶下间隙脓肿4例、多间隙脓肿6例、颞下脓肿2例。脓肿大小范围约在1.6 cm×1.3 cm×2.0 cm-3.5 cm×4.1 cm×3.0 cm之间。分组方法：根据入院先后顺序将患者随机分为两组，穿刺抽脓加闭式冲洗组66例，传统方法对照组65例。 　　1.2 统计学处理 SAS 6.12软件进行统计学处理。 　　1.3 方法 器材准备,20 ml注射器及相应针头两只；0.9%氯化钠注射液；0.2%甲硝唑注射液；抗生素溶液；2%利多卡因注射液。首次操作前须经局部B超确定脓肿的位置及范围［2］。 　　颌面部脓肿患者,取半卧位或卧位,消毒皮肤,先在穿刺点皮下注少量2%利多卡因,以减轻疼痛,一人用一支20 ml注射针在隆起最明显处,并尽量偏脓肿低位刺入,另一人用另一支20 ml注射针在脓肿高位刺入脓腔，脓肿低位注射器开始抽脓，抽尽脓液后高