全面部骨折38例临床分析.docVIP

全面部骨折38例临床分析 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：全面部骨折38例临床分析 1 1 一般资料 2 2 治疗方法 3 1 全面部骨折临床特点 4 2 全面部骨折的 治疗 4 文2：原发性输尿管癌38例临床分析 6 1 资料与方法 6 2 结 果 7 3 讨 论 7 参考文摘引言： 10 原创性声明（模板） 11 文章致谢（模板） 11 正文 全面部骨折38例临床分析 文1：全面部骨折38例临床分析 Abstract： Objective To investigate the clinical characteristics and operative effect of panfacial Totally 38 patients records from to were associated with causes,characteristics,treatment methods were The most common cause of trauma was traffic accident(33 cases,%),including 19 cases of motorcycle accident(%).In relation to fractures,nasal bone was the most common fracture site besides maxilla and mandible,and most of them were comminuted fractures,followed by zygomatic most cases,linear fractures were found in mandible,and varieties were showed in maxillary,including bilateral fractures,split of medial palate,comminuted fracture in anterior surface of maxillary sinus,separation of zygomaticomaxilla suture the cases received surgical treatment and rigid internal sequence of reduction and fixation followed the steps from bottomtotoptomiddle in the clinical results were gained except one,because of severe Panfacial fractures are serious injuries because they involve important adjacent structures,and increase difficulties in restoring their clinical results can be obtained following the recommended operatio. Key words：facial fracture;surgery 全面部骨折(panfacial fracture)主要指面中1/3和面下1/3骨骼同时发生的骨折，包括上、下颌骨，颧骨、颧弓、眼眶、鼻骨等。常造成面部严重畸形和咬合关系紊乱等功能障碍，且经常并发有颅脑和全身其他部位损伤，该区域的骨折是口腔颌面部损伤治疗的难点[1]。本文收集了我科5年来38例全面部骨折患者的病历资料，对致伤原因、骨折特点和治疗方法进行了分析和探讨。 临床资料 1 一般资料 我院2003年10月～2008年10月收治全面部骨折38例，其中男性32例，女性6例;年龄17～54岁，平均31岁。致伤原因：道路交通伤33例(其中摩托车伤19例)，机器飞出物击伤3例，坠落伤2例。21例伴有颅脑损伤，19例伴有全身其他部位骨折，2例伴有腹部脏器伤。术前拍摄全口曲面断层片、瓦氏位片、面部轴状CT扫描，部分患者行颌面骨三维CT重建。 2 治疗方法 21例伴有颅脑伤，其中14例伤情较重，于神经外科治疗7～14天后接受手术，其余均急诊手术。1例伴有腹部脏器伤患者急诊术后并发症死亡。全部患者均采用经鼻腔气管插管静脉复合麻醉，打上下颌牙弓夹板。手术采用上颌和下颌口腔前庭切口，部分患者辅以下睑的睑缘切口。手术中依照下颌骨骨折部位，先行下颌前庭沟切口，显露下颌骨骨折端，解剖复位，小型和微型钛板坚强内固定。下颌骨骨折段固定