老年患者颌面颈多间隙感染的多因素预后分析  

Multivariate Analysis of Prognostic factors in Multi-space Infections of the Oral and Maxillofacial and Neck in the Aged Patients

作　　者：姜军松 杨震[2] 庾若琪 朱佳 韩华 汪庆 王丹[2] 

机构地区：[1]东部陆军九八医院口腔颌面外科,副主任医师浙江313000 [2]南京军区总医院口腔颌面外科,主任医师南京210002

出　　处：《中华老年口腔医学杂志》2016年第5期290-294,共5页Chinese Journal of Geriatric Dentistry

摘　　要：目的:分析颌面颈多间隙感染老年患者的临床特征,运用多变量统计模型确定严重并发症及总住院时间预后独立影响因子。方法:对两家三级甲等医院口腔颌面外科收治的285例诊断为颌面颈多间隙感染的病例进行回顾性分析。所有病例根据年龄分为老年组和成年组。研究内容包括一般资料、临床指标(全身系统性疾病、病因、症状发作到入院治疗的时间、受累间隙的数量和分布)、实验室检查和治疗结果(切口数量、住院天数和并发症)。采用SAS 8.0软件包对数据进行t检验、Fisher's确切概率和X^2检验分析。结果:颈部多间隙感染是预测严重并发症的独立影响因子(odds ratio,OR=2.45);并存病(OR=2.10)、非牙源性感染源(OR=1.89)、白细胞总数>12.0×10~9/L(OR=3.57)、切开引流前C反应蛋白>150mg/L(OR=2.18)、同时需要外科与全身治疗(OR=4.66)是预测总住院时间的独立影响因子。结论:多因素预后分析可有效揭示颌面颈多间隙感染的独立危险因素,为临床上治疗老年颌面颈多间隙感染提供了重要的参考依据。Objective：This study aimed to retrospective analyze the difference between the aged patients（≥65 years）and adults（〈65 years） with multi-space infections of the head and neck.Using multivariate staistical models to identify independent significant factors.Methods：285 patients received treatment for severe multi-space infections of the head and neck region.Demographics,clinical parameters（the coexisting coditions,the etiology,the length between first symptomatic onsed and admission,the number of spaces affected,and the distribution of incolved spaced）.laboratory values（bacteriology,admission blood glucose level,adimission white blood cell count,and CPR on admission）and treatment parameters（the number of incisions,complications and length of hospital stay） were collected and analyzed for their clinical significance.Statistical analyses between groups were performed using the Student test.Fisher＇s exact test,and chi-square.Results：Using logistic regression analyses,involvement of neck muti-space was independently significant in prognosticating servere complications[odds ratio（OR）2.57],leukocyte counts 〉12.0×10^9/L（OR=3.57）,the presence of comorbidities（OR= 2.10）,non-odontogenic site of origin（OR= 1.89）,preoperative CRP〉150mg/L（OR=2.18）,the need for both medical and surgical treatments（OR= 4.66） was significantly and independently prognostic of long hospital stays.Conclusions：Multivariate analysis can distinguish between risk factors and their relative contribution to outcome in the aged patients with multi-space infections of the head and neck.

关 键 词：颌面颈部 多间隙感染 老年 多因素分析 预后 

分 类 号：R782.3[医药卫生—口腔医学]