口腔颌面部异物36例临床分析

目的:探讨口腔颌面部异物伤的诊断与治疗及影像学诊断的重要性。方法 :选择2003-01—2010-12期间收治的,影像和病历资料完善的口腔颌面部异物存留伤36例。分析异物类型,并对临床疗效进行评估。结果:36例异物存留伤患者中,金属异物12例,非金属异物24例。择期异物取出26例;需要急诊清创者10例,而清创术可一期取出异物者6例,4例延期取出。30例经常规X线片检查后,需经CT或三维CT检查进一步定位,评估手术取出的可行性及风险。其中26例经手术取出,4例保留并观察。结论:三维CT在非金属异物存留伤诊疗中起到重要的作用;必须根据异物大小、部位及与周围大血管的毗邻关系,患者全身情况等综合因素判定是否手术及手术时机。

Management on Foreign Bodies in the Oral and Maxillofacial Region

Objective: To summarize the diagnosis and treatment on foreign bodies’ injuries in maxillofacial region,and special emphasis was paid on radiology examination.Methods: 36 foreign body injury cases from Jan 2003 to Nov 2010 were retrospectively reviewed.All patients underwent routine X-ray examination to locate the foreign bodies,while 30 patients need further examined by CT or three-dimensional CT(3D-CT) to evaluate whether the foreign bodies were adjacent to great vessels and nerves,feasibility of the removal and possible risk factors.There were 12 metallic foreign bodies,24 non-metallic foreign bodies.In 10 cases with early debridement,6 foreign bodies were removed immediately,other 4 waited to selective surgery.In 26 cases,foreign bodies were eliminated by selective surgery.Results: 32 foreign bodies were eliminated immediately or later,the other 4 cases were left in bodies and followed-up.Conclusion: 3D CT played an exclusive important role in diagnosis and treatment for non-metallic foreign body injuries.According to their size,location and adjacent to great vessels,we can decide whether and when elimination begins.