糖尿病合并颌面间隙感染患者的诊断与治疗研究  

Diagnosis and treatment of diabetes mellitus patients complicated with maxillofacial space infections

作　　者：杨峻[1] 林勇[2] 陈骏[1] 闵莉芳[1] 金晶 董陈[1] YANG Jun;LIN Yong;CHEN Jun;MIN Li-fang;JIN Jing;DONG Chen(Li Huili Hospital of Ningbo Medical Center,Ningbo,Zhejiang 315041,China)

机构地区：[1]浙江省宁波市医疗中心李惠利医院口腔科,浙江宁波315041 [2]河南省濮阳市油田总医院口腔颌面外科,河南濮阳457001

出　　处：《中华医院感染学杂志》2018年第14期2151-2154,共4页Chinese Journal of Nosocomiology

摘　　要：目的探究糖尿病合并颌面间隙感染患者的诊断与治疗。方法选取医院2013年1月-2017年1月收治的糖尿病合并颌面间隙感染患者88例作为糖尿病组,另选取87例同期单纯颌面间隙感染患者作为非糖尿病组,患者均行全身CT及血液、肝肾功能、细菌培养、生化功能、血常规、脓液培养及药敏试验检查,对患者的实验室检查结果、感染部位及来源、治疗结果进行总结分析。结果糖尿病组患者白细胞总数、中性粒细胞百分数、空腹血糖高于非糖尿病组,血浆清蛋白低于非糖尿病组;两组患者脓液培养呈阳性的患者72例,共检出病原菌88株,其中革兰阴性菌44株,革兰阳性菌44株;糖尿病组的主要感染部位为多间隙感染,两组差异有统计学意义(P<0.05);两组主要感染来源均为牙源性感染,差异无统计学意义;行改良切口手术患者及行负压封闭引流术患者切口平均愈合时间、皮肤瘢痕长度及宽度差异无统计学意义。结论糖尿病合并颌面间隙感染患者感染状况严重,故临床应对其进行负压封闭引流术及改良手术切口对患者进行治疗,可有效减少患者创口愈合时间、住院时间,提高治疗效果。OBJECTIVE To explore the diagnosis and treatment of diabetes mellitus patients complicated with maxillofacial space infections.METHODS Totally 88 diabetes mellitus patients complicated with maxillofacial space infections who were treated in hospitals from Jan 2013 to Jan 2017 were assigned as the diabetes mellitus group,meanwhile,87 patients with single maxillofacial space infections were set as the non-diabetes mellitus group.All of the patients received the examinations,including whole-body CT,blood,liver and kidney function,bacterial culture,biochemical function,blood routine,pus culture and drug susceptibility testing.The results of laboratory examinations,infection sites,infection sources and treatment outcomes were observed.RESULTS The total white blood cells counts,percentage of neutrophils and fasting blood glucose level of the diabetes mellitus group were higher than those of the non-diabetes mellitus group,while the plasma albumin level of the diabetes mellitus group was lower than that of the non-diabetes mellitus group.A total of 88 strains of pathogens were isolated from 72 patients who were positive for pus culture,44 of which were gram-positive bacteria,and 44 were gram-positive bacteria.The maxillofacial space was the major infection site in the diabetes mellitus group,and there was significant difference between the two groups（P〈0.05）.The odontogenic infection was the major infection source,and there was no significant difference.There was no significant difference in average healing time of incision,length or width of skin scar between the patients who underwent modified incision surgery and the patients who underwent vacuum sealing drainage.CONCLUSIONThe diabetes mellitus patients complicated with maxillofacial space infection have severe infection,therefore,it is necessary to treat the patients undergoing vacuum sealing drainage and modified incision surgery so as to effectively shorten the wound healing time and length of hospital stay and improve therapeutic effect.

关 键 词：糖尿病 颌面间隙 感染 诊断 治疗 

分 类 号：R587.1[医药卫生—内分泌]