口腔颌面部蜂窝织炎临床的的特点及治疗的探讨.docVIP

口腔颌面部蜂窝织炎临床的的特点及治疗的探讨 　　doi：10.3969/j.issn.1007-614x.2014.11.49 　　摘 要 目的：探讨口腔颌面部蜂窝织炎临床特点及治疗。方法：收治口腔颌面部蜂窝织炎患者50例作为研究对象，依据临床特点，制定规范方案治疗。结果：本组50例患者，治愈49例（98%），无效转院1例，平均病程（15.8±2.1）天，其中有糖尿病合并者病程相对较长，部分超过1个月。结论：针对口腔颌面部蜂窝织炎，依据临床特点，早重视及诊治，行抗感染、局部切开引流及手术等，可明显改善预后，对提高患者生存质量有非常重要的意义。 　　关键词 口腔颌面部蜂窝织炎 临床特点 治疗 　　Clinical characteristics and investigation of treatment of oral and maxillofacial cellulitis 　　Zhao Qiong 　　Department of Stomatology，the Peoples Hospital of Guandu District of Kunming City，Yunnan 650200 　　Abstract Objective：To explore the clinical characteristics and treatment of oral and maxillofacial cellulitis.Methods：50 patients with oral and maxillofacial cellulitis were selected.We developed a standard treatment plan for each patient according to the characteristics.Results：In 50 patients of this group，49 cases（98%） were cured，1 case was invalid and transferred to other hospital.The average course of disease was 15.8±2.1 days；among them，the course of disease of patients complicated with diabetic patients was relatively longer，some were more than one month.Conclusion：Early attention and diagnosis and treatment，anti-infection，local incision drainage and operation according to the clinical characteristics of oral and maxillofacial cellulitis，can significantly improve the prognosis，and it is very important to improve the quality of life of patients. 　　Key words Oral and maxillofacial cellulitis；Clinical characteristics；Treatment 　　口腔科常见疾病类型中，口腔颌面部蜂窝织炎占有较高的病发比例，又称口腔颌面对间隙感染，多为继发性。由腺源性感染即涎腺炎、扁桃体炎、淋巴结炎和牙源性感染牙源性颌骨骨髓炎、牙槽脓肿、智齿冠周炎扩散所致，血源性、医源性、损伤性感染少见[1]。本次研究选择相关病例，就临床资料回顾如下。 　　资料与方法 　　选择研究对象50例，男32例，女18例，年龄5～79岁，平均（57.2±1.3）岁，60岁27例，病程7～14天。其中伴类风湿关节炎5例，伴糖尿病10例。大部分患者以面部明显肿胀、不对称、张口受限、疼痛、无法进食为主要表现。感染部位：嚼肌间隙6例，颌下间隙19例，翼下颌间隙4例，眶下间隙10例，口底间隙4例，颊间隙7例。感染来源：医源性感染3例，牙源性感染32例，损伤性感染5例，腺源性感染10例。均依据临床体征、症状、发病部位、病史询问结果诊断，并常规辅以脓液细菌培养、脓腔穿刺、血常规检查及药敏试验，特殊部位可用CT检查，以与肿瘤鉴别，避免误诊。 　　方法：①健康宣教：就口腔颌面部蜂窝织炎病发原因、可能出现的并发症、预计病程、治疗方案向患者解释，为防炎症扩散，勿挤压、热敷。避免炎症部位运动，注意休息，做好营养补充。②药物治疗：对患者己用药物药理作用、种类进行了