颌骨骨折治疗失败48例原因分析  

Treatment Failure Analysis of 48 Cases of Maxillofacial Fractures

作　　者：王岳森[1] 克热木.阿巴司 龚忠诚[1] 刘慧[1] 

机构地区：[1]新疆医科大学第一附属医院颌面肿瘤外科新疆医科大学口腔医学院新疆维吾尔自治区口腔医学研究所,乌鲁木齐830054

出　　处：《临床误诊误治》2016年第3期70-73,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金(31260229);新疆维吾尔自治区青年科技创新人才培养工程项目(2014721046)

摘　　要：目的探讨颌骨骨折术后并发症的特点并分析一期治疗失败的原因。方法收集2010年1月—2014年12月我院收治的在外院一期治疗失败的颌骨骨折48例的临床资料,分析一期治疗失败的原因。结果本组一期治疗后发生术后感染18例,咬合关系紊乱13例,开口受限11例,颜面畸形6例,神经损伤6例。分析治疗失败的主要原因:1首诊医师非颌面外科医师,术前评估不足,手术操作不当,复位不准确;2固定材料、方法及位置选择不当,不适当的应力集中;3忽视术后颌间牵引;4患者依从性差;5术后感染,护理不当。结论临床应掌握颌面部骨折的治疗原则及正确方法,选择内固定材料、方法及部位要得当,不可过分依赖内固定而忽视必要的颌间牵引。Objective To investigate the characteristics of postoperative complications and analyze the cause of the treatment failure of maxillofacial fractures primarily treated in the other hospitals. Methods 48 cases of jaw fracture with primary failure treatment in other hospitals admitted to our hospital during 2010 and 2014 were included,and the cause of failure treatment was analyzed. Results In these cases,there were 18 cases with postoperative infection,13 cases with occlusion disorders,11 cases with limitation of mouth opening,6 cases with facial deformity and 6 cases with nerve injury. The main causes of the failure of treatment were as follows： 1 The diagnosis doctor was not a maxillofacial surgeon,insufficient preoperative evaluation,inadequate operation,inaccurate reduction; 2Improper internal fixation materials,methods and sites,inappropriate stress concentration; 3The short-term intermaxillary fixation was neglected; 4The poor compliance of patients; 5Postoperative infection,improper nursing. Conclusion It is important to master the principle and right methods of jaw fracture treatment. Internal fixation materials,methods and sites should be appropriate. The short-term intermaxillary fixation is essential.

关 键 词：颌骨骨折 治疗失败 手术后并发症 

分 类 号：R782.4[医药卫生—口腔医学]