口腔颌面部间隙感染临床特征及病原学特征分析  

Research on the clinical characteristics and etiological features of oral and maxillofacial space infections

作　　者：万超 张方 房欢欢 徐兆源 WAN Chao;ZHANG Fang;FANG Huanhuan;XU Zhaoyuan(Department of Oral and Macillofacial Surgery,the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital of Wannan Medical College),Wuhu 241000,Anhui,China)

机构地区：[1]皖南医学院第一附属医院口腔颌面外科,安徽芜湖241000

出　　处：《中国病原生物学杂志》2025年第5期606-609,613,共5页Journal of Pathogen Biology

基　　金：安徽省高校自然科学基金重点项目(No.2024AH051936);皖南医学院中青年科研基金(No.WK2023ZQNZ46)。

摘　　要：目的探析口腔颌面部间隙感染的临床表现、病原体分布及血清炎性因子水平,以期提高临床诊疗效率并优化治疗方案。方法分析85例口腔颌面部间隙感染患者感染来源及感染部位分布情况,采集患者脓液标本进行病原菌培养和血清炎性因子检测。对比单间隙感染与多间隙感染组患者基本特征及不同感染程度患者血清C反应蛋白(CRP)、降钙素原(PCT)、D-二聚体(D-D)的水平差异。结果在85例口腔颌面部间隙感染患者中,主要为牙源性感染(64.71%),腺源性、医源性、外伤性、血源性感染占比分别为18.82%、10.59%、3.53%、2.35%。单间隙感染占比为63.53%,包括眶下间隙、咬肌间隙、颊间隙、颌下间隙、舌下间隙、翼颌间隙、咽旁间隙、颏下间隙、颞下间隙。多间隙感染占36.47%,包括眶下+咬肌间隙、眶下+颊间隙、咬肌+翼颌间隙、眶下+颞下间隙、颌下+舌下间隙、眶下+咽旁间隙、眶下+咬肌+颊间隙。共检出88株病原菌,革兰阳性菌占60.23%,革兰阴性菌占29.55%,真菌占10.23%。革兰阳性菌中,金黄色葡萄球菌最多,占17.05%,其次是草绿色链球菌,占13.64%。革兰阴性菌中,普雷沃氏菌最多,占7.95%。真菌中,白色假丝酵母菌最多,占7.95%。口颌面部单间隙感染与多间隙感染患者年龄、文化程度、感染来源、治疗方式、吸烟史、酗酒史差异有统计学意义(P<0.05),性别差异无统计学意义(P>0.05)。85例口腔颌面部间隙感染患者中,42例为轻度感染,35例为中度感染,8例为重度感染。轻度感染组患者血清CRP水平为(62.65±26.32)mg/L,血清PCT水平为(2.01±1.06)ng/mL,血清D-D水平为(331.57±125.92)μg/L;中度感染组患者血清CRP水平为(79.74±25.31)mg/L,血清PCT水平为(3.81±1.46)ng/mL,血清D-D水平为(545.86±156.1)μg/L;重度感染组患者血清CRP水平为(113.69±66.25)mg/L,血清PCT水平为(4.9±2.1)ng/mL,血清D-D水平为(946.61±315.29)μg/L;对照组患者血清CRP�Objective To explore the clinical manifestations,pathogen distribution and levels of serum inflammatory factors of oral and maxillofacial space infections,with the aim of improving the efficiency of clinical diagnosis and treatment and optimizing treatment plans.Methods The sources of infection and the distribution of infection sites in 85 patients with oral and maxillofacial space infections were analyzed.The pus specimens from the patients were collected for pathogen culture and detection of serum inflammatory factors.The basic characteristics of patients in the single-space infection group and the multi-space infection group were compared,as well as the differences in the levels of serum C-reactive protein(CRP),procalcitonin(PCT),and D-dimer(D-D)among patients with different degrees of infection.Results Among the 85 patients with oral and maxillofacial space infections,odontogenic infections were predominant(64.71%).The proportions of adenogenic,iatrogenic,traumatic and hematogenous infections were 18.82%,10.59%,3.53% and 2.35% respectively.The proportion of single-space infections was 63.53%,including the infraorbital space,masseter space,buccal space,submandibular space,sublingual space,pterygomandibular space,parapharyngeal space,submental space and infratemporal space.Multiple-space infections accounted for 36.47%,including infraorbital+masseter space,infraorbital+buccal space,masseter+pterygomandibular space,infraorbital+infratemporal space,submandibular+sublingual space,infraorbital+parapharyngeal space,and infraorbital+masseter+buccal space.A total of 88 strains of pathogenic bacteria were detected,with Gram-positive bacteria accounting for 60.23%,Gram-negative bacteria accounting for 29.55%,and fungi accounting for 10.23%.Among the Gram-positive bacteria,Staphylococcus aureus was the most common,accounting for 17.05%,followed by Streptococcus viridans,accounting for 13.64%.Among the Gram-negative bacteria,Prevotella was the most common,accounting for 7.95%.Among the fungi,Candida albicans was the most

关 键 词：口腔颌面部间隙感染 临床特征 病原菌 

分 类 号：R782.3[医药卫生—口腔医学]