口腔颌面部间隙感染的临床特征及预后影响因素分析  

Clinical characteristics and prognostic factors of oral and maxillofacial space infection

作　　者：韩静欣 林道志[1] 石中文 黄谢山[1] 吴江 HAN Jingxin;LIN Daozhi;SHI Zhongwen;HUANG Xieshan;WU Jiang(Haikou People's Hospital,Hainan Province,Haikou 570208)

机构地区：[1]海南省海口市人民医院,570208 [2]联勤保障部队第九八二医院五官科

出　　处：《现代口腔医学杂志》2024年第1期19-22,共4页Journal of Modern Stomatology

基　　金：海南省卫生健康委员会科研项目(21A200391)。

摘　　要：目的探讨口腔颌面部间隙感染患者表现的临床特征及患者预后影响因素。方法选择2020年6月~2023年1月在海口市人民医院住院治疗的213例口腔颌面部间隙感染患者作为观察对象,观察患者住院期间预后情况,分析口腔颌面部间隙感染病原菌分布,收集患者临床资料,Logistic回归分析口腔颌面部间隙感染患者预后影响因素。结果213例患者感染部位主要感染部位在下颌下间隙、眶下间隙、嚼肌间隙与颊间隙,其中下颌下间隙感染率最高,为34.74%(74/213),其次为眶下间隙感染,感染率为21.13%(45/213);感染来源主要为牙源性感染,其次为腺源性感染;213例患者中有197例培养出病原菌,共培养出病原菌204株,其中革兰氏阳性菌118株(57.84%),主要以金黄色葡萄球菌与溶血链球菌为主;革兰氏阴性菌86株(42.16%),主要以大肠埃希菌和铜绿假单胞菌为主;213例患者发生预后不良47例,其中呼吸梗阻13例,肺炎12例,心包炎3例,脓毒症4例,胸腔积液13例,2例死亡。与预后良好组比较,预后不良组年龄≥60岁、合并糖尿病患者比例、病程、住院时间、累及多间隙、多重致病菌感染患者比例及血清CRP、WBC、Neu水平显著升高(P<0.05);多因素Logistic回归分析结果显示,年龄、合并糖尿病、病程、累及多间隙、多重致病菌感染是影响口腔颌面部间隙感染患者预后的独立危险因素(P<0.05)。结论口腔颌面部间隙感染主要发生于下颌下间隙,以牙源性感染为主,致病菌以革兰氏阳性病原菌为主,患者预后主要受年龄、合并糖尿病、病程、累及间隙、多重致病菌感染等因素的影响。Objective To investigate the clinical features and prognostic factors of patients with oral and maxillofacial space infection.Methods A total of 213 patients with oral and maxillofacial space infection who were hospitalized in haikou people's hospital from June 2020 to January 2023 were regarded as observation objects,the prognosis of the patient was observed during hospitalization,the distribution of pathogenic bacteria of oral and maxillofacial space infection was analyzed,clinical data of patients were collected,Logistic regression was applied to analyze prognostic factors in patients with oral and maxillofacial space infection.Results The main infection sites of 213 patients were submaxillary space,suborbital space,masseter space and buccal space,among them,the infection rate of submaxillary space was the highest,34.74%(74/213),followed by infraorbital space infection,21.13%(45/213);the main source of infection was odontogenic infection,followed by adenogenic infection;among the 213 patients,197 were cultured with 204 strains of pathogenic bacteria,of which 118 were Gram-positive bacteria(57.84%),mainly Staphylococcus aureus and Streptococcus haemolyticus;86 strains(42.16%)were Gram-negative bacteria,mainly Escherichia coli and Pseudomonas aeruginosa;there were 47 cases of poor prognosis in 213 patients,including 13 cases of respiratory obstruction,12 cases of pneumonia,3 cases of pericarditis,4 cases of sepsis,13 cases of pleural effusion,and 2 cases of death.Compared with the good prognosis group,the proportions of patients with poor prognosis≥60 years old and complicated with diabetes,duration of disease,hospital stay,the proportion of patients with multiple spaces and multiple bacterial infections,and serum CRP,WBC,Neu levels were obviously higher than those in the poor prognosis group(P<0.05);Multivariate logistic regression analysis showed that age,diabetes,course of disease,involvement of multiple spaces,and multiple pathogenic bacteria infection were independent risk factors affecting the prognosis

关 键 词：口腔颌面部间隙感染 预后 病原菌分布 

分 类 号：R782.3[医药卫生—口腔医学]