糖尿病患者口腔颌面部多间隙感染的临床特征分析  

The clinical features of severe multi-space infections of the head and neck in patients with diabetes mellitus compared to non-diabetic patients

作　　者：郑凌艳[1] 张伟杰[1] 杨驰[1] 蔡协艺[1] 姜滨[1] 王保利[1] 浦益萍[1] 金佳敏[1] 王婧[1] 张志愿[1] 周龙女[2] 周健[2] 管欣[3] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院急诊科,上海200011 [3]上海交通大学医学院附属第九人民医院胸外科,上海200011

出　　处：《中国口腔颌面外科杂志》2012年第6期473-477,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(81100766);上海市科学技术委员会医学引导类基金(08DZ2271100;10411964400);上海市重点学科建设项目(S30206);上海高校创新团队发展计划;上海市卫生局基金(2007008);上海交通大学医学院校基金(YZ1024)~~

摘　　要：目的:通过与非糖尿病患者的比较,分析口腔颌面部多间隙感染的糖尿病患者的临床特征。方法:对上海第九人民医院口腔颌面外科收治的191例诊断为口腔颌面部多间隙感染的病例进行回顾分析。根据有无罹患糖尿病分为糖尿病组和非糖尿病组。研究内容包括一般资料、病因学、临床指标(症状发作到入院治疗的时间、受累间隙的数量和分布)、实验室检查(细菌学、入院血糖水平、入院血白细胞总数和中性粒细胞百分比)和治疗结果(切口数量、住院天数和并发症)。采用SAS8.0软件包对数据进行t检验、χ2检验和方差分析。结果:2组患者中,牙源性感染是最常见的病因,最容易受累的间隙是下颌下间隙。糖尿病组分离出的最常见的细菌是肺炎克雷伯菌,而非糖尿病组是链球菌。与非糖尿病相比,口腔颌面部多间隙感染的糖尿病患者受累的间隙更多,切开引流的切口数量更多,住院时间更长,全身各种并发症更多见,严重者可导致死亡。结论:通过与非糖尿病患者比较,本研究揭示了口腔颌面部多间隙感染中的糖尿病患者的临床特征,为临床上治疗糖尿病口腔颌面部多间隙感染提供了重要的参考依据。PURPOSE： To analyze the clinical features of diabetic patients with multi-space infections of the head and neck by comparing them to nondiabetic patients in order to render effective health care to this patient population. METHODS： A retrospective study was conducted on 191 patients receiving treatment for severe multi-space infections of the head and neck region. Demographics, etiology of infection, clinical parameters, laboratory values （bacteriology, blood glucose level on admission, white blood cell count on admission, and percent of neutrophil on admission） and treatment parameters （the number of incisions, complications and length of hospital stay） were collected and analyzed for clinical significance. Statistical analyses of the results between the two groups were performed using Student＇ s t test, Chi- square test, and analysis of variance with SAS 8.0 software package. RESULTS： Odontogenie infections were the most common cause and the most commonly affected facial space was the submandibular space in both groups. The most commonlyisolated organism in diabetes was Klebsiella pneamoniae, whereas Streptococcus spp in non-diabetic patients. Compared with nondiabetic patients, diabetics had more concurrently involved spaces, required more incisions for drainage, had longer hospital stays, and had more complications. Some even succumbed to death. CONCLUSION： This study has determined the differences in clinical features of patients with multi-space infections of the head and neck by comparing diabetic patients to non-diabetic patients, which may help manage or create protocols in treating the diabetic patients with these types of infections. Supported by National Natural Science Foundation of China （81100766）,Research Fund of Science and Technology Commission of Shanghai Municipality （08DZ2271100, 10411964400）, Shanghai Leading Academic Discipline Project （S30206）, Program for Innovative Research Team of Shanghai Municipal Education Commission, Fund of Shanghai Municipal Health Bu

关 键 词：糖尿病 口腔颌面部 多间隙感染 

分 类 号：R782.3[医药卫生—口腔医学]