糖尿病患者口腔颌面部间隙感染临床及细菌学分析  

The clinical and bacteriological analysis of the diabetic with oral and maxillofacial space infections

作　　者：于珊珊[1,2] 李涛 董刚[3] 李凤梅[3] 郑建金[3] 

机构地区：[1]青岛大学附属青岛市立医院口腔科,山东青岛266011 [2]青岛兰信新都口腔医院,山东青岛266000 [3]青岛市立医院口腔科,山东青岛266011

出　　处：《口腔疾病防治》2018年第1期43-47,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：青岛市科技计划项目(15-9-2-79-nsh)

摘　　要：目的分析糖尿病和非糖尿病患者口腔颌面部间隙感染的临床特点,了解糖尿病患者常见致病菌及敏感的抗生素种类,为临床用药提供参考依据。方法口腔颌面部间隙感染病例61例,分为糖尿病组和非糖尿病组,比较2组患者年龄、性别、感染来源、病原菌、抗菌药物敏感性、空腹血糖水平、血白细胞总数和中性粒细胞百分比、住院天数。结果 2组患者中,牙源性感染均是最常见的病因,最容易受累的间隙是颌下间隙,最常见的致病菌均为链球菌,最敏感的药物是万古霉素,其次为左氧氟沙星、头孢噻肟。糖尿病组患者年龄、空腹血糖值及住院天数高于非糖尿病组。结论糖尿病颌面部间隙感染患者,在未取得细菌培养及药敏试验结果之前,可以常规使用左氧氟沙星及头孢噻肟,并根据口腔颌面部的解剖结构,联合使用抗厌氧菌药物,如替硝唑等,最终依据药敏结果用药。Objective To analyze the clinical characteristics of oral and maxillofacial space infection between the diabetic and non-diabetic patients and to explore the common pathogenic bacteria and antibiotic sensitivity of diabetic patients, to guide the clinical medication. Methods A retrospective study was conducted on 61 patients who received treatment in Qingdao municipal hospital affiliated to Qingdao university, between December 2014 and December 2016 with Oral and maxillofacial space infection. The 61 patients were divided into diabetic group and non-diabetic group.The research contented the patients＇age, sex, source of infection, pathogenic bacteria, antibacterial drugs sensitivity, fasting blood glucose levels, white blood cell total and neutrophils percentage, and days of hospitalization. T test and chisquare test in SASS.19.0 software was used. Results In the 2 groups of patients, the most common etiological factor was odontogenic infection; the most easiest affected space was submandibular space. The most common pathogenic bacteria were streptococcus. Vancomycin was the most sensitive drug, then levofloxacin and cefotaxime. In addition, the diabetes patients＇age, fasting blood glucose levels and hospitalization days were significantly higher than non-diabetic patients＇. Conclusion For the diabetic patients with maxillofacial space infection, levofloxacin and cefotaxime was first used for the conservative treatments when the results of the bacterial culture and drug susceptibility test are not obtained. Meanwhile, according to the oral and maxillofacial anatomy, combination of anti-anaerobic agents such as Tinidazole is also suggested. But the final situation of medication is based on the result of the drug susceptibility test.

关 键 词：糖尿病 口腔 颌面部 间隙感染 病原菌 抗菌药物敏感性 

分 类 号：R782[医药卫生—口腔医学]