影响牙源性口腔颌面颈部多间隙感染治疗效果的危险因素  

Risk factors of the treatment outcomes for multispace infections of the oral,maxillofacial,and cervical regions of odontogenic origin

作　　者：丛麒峰 付洪海[1] 王芳[1] 孙乐刚[1] CONG Qifeng;FU Honghai;WANG Fang;SUN Legang(Department of Oral and Maxillofacial Surgery,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;School of Stomatology,Binzhou Medical University,Yantai 264003,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院口腔颌面外科,山东滨州256603 [2]滨州医学院口腔医学院,山东烟台264003

出　　处：《滨州医学院学报》2024年第3期196-200,205,共6页Journal of Binzhou Medical University

基　　金：山东省自然科学基金(ZR2018PH023)。

摘　　要：目的回顾性分析牙源性颌面颈部多间隙感染患者的临床资料,旨在揭示影响牙源性颌面颈部多间隙感染治疗效果的危险因素,以期为临床上关于此类感染的早期病情评估、干预治疗策略的制定及住院时间的预测提供理论支撑。方法统计患者一般资料(年龄、性别)、CT结果(感染间隙名称以及数量)、实验室检查、就诊前病程、住院前是否接受输液治疗、是否伴有糖尿病。结果38例患者住院时间超过15 d的发生率为68.42%。颌下间隙为最常受累间隙可通过ln(住院天数)=2.117+0.02×(间隙感染个数)+0.409×(颈部间隙个数)+0.48×(舌下间隙感染个数)+0.074×(颏下间隙感染个数)+0.013×(第一次白细胞计数×109/L)+1×(中细粒细胞百分比)-0.316×(翼下颌间隙感染个数)-0.318×(颊间隙感染个数)-0.236×(颏下间隙感染个数)。结论年龄、白细胞计数、中性粒细胞百分比、感染间隙的数量、感染累及颌下间隙、翼下颌间隙、颊间隙、颈部间隙、舌下间隙、颏下间隙为危险因素。感染累及颌下间隙、翼下颌间隙、颊间隙对于延长住院时间的影响小于颏下间隙、颈部间隙、咽旁间隙。Objective To retrospectively analyze the clinical data from patients with odontogenic maxillofacial and cervical multi-space infections,to identify key risk factors affecting the treatment outcomes of such infections,and to provide theoretical support for the early assessment of the condition,the formulation of intervention treatment strategies,and the prediction of hospital stay duration in clinical practice.Methods The study covered general data(age,gender),CT findings(names and number of infected spaces),laboratory tests,duration of illness before visit,pre-admission intravenous treatment,and presence of diabetes.Results Thirty-eight patients had a hospital stay exceeding 15 days in 68.42%of cases.The submandibular space was the most frequently involved,and the length of hospital stay could be predicted by ln(hospital days)=2.117+0.02(number of infected spaces)+0.409×(number of cervical spaces)+0.48×(number of sublingual space infections)+0.074×(number of submental space infections)+0.013×(first white blood cell count×109/L)+1×(percentage of band neutrophils)-0.316×(number of pterygomandibular space infections)-0.318×(number of buccal space infections)-0.236×(number of submental space infections).Conclusion Age,white blood cell count,percentage of neutrophils,number of infected spaces,and involvement of the submandibular,pterygomandibular,buccal,cervical,sublingual,and submental spaces are risk factors.Infections involving the submandibular,pterygomandibular,and buccal spaces have a lesser impact on extending hospital stay compared to the submental,cervical,and parapharyngeal spaces.

关 键 词：口腔颌面颈部 多间隙感染 住院时间 影响因素 

分 类 号：R782.3[医药卫生—口腔医学]