腐败坏死性口底蜂窝织炎35例治疗

目的:通过对腐败坏死性口底蜂窝织炎病例的回顾性分析,总结该病特点,以提高其治愈率。方法:收集1982～2003年经治的腐败坏死性口底蜂窝织炎的住院患者35例,分析其感染来源、细菌培养结果、全身症状及局部表现、体温、化验结果及其治疗方法。结果:本组35例,29例痊愈,因并发症而救治无效6例死亡,病死率17%。结论:腐败坏死性口底蜂窝织炎全身症状严重,并发症多,病情进展快,病死率高。应早其积极治疗,根据患者情况选用敏感抗生素,主张联合、足量,加强支持治疗,纠正酸碱平衡紊乱,及时切开引流,处理原病灶等综合治疗,才能有效的控制病情,尽快治愈。     

口腔颌面部炎症

12例儿童重症口底蜂窝织炎分析；下颌骨边缘性骨髓炎208例临床总结；下颌第二磨牙冠周炎致面颊瘘1例；面部皮脂腺囊肿感染后的小切口治疗     

急性腐败坏死性口底蜂窝织炎30例临床分析

目的：总结急性腐败坏死性口底蜂窝织炎的诊治经验。方法：对1995～2004年收治的30例急性腐败坏死性口底蜂窝织炎的临床资料进行回顾性分析。结果：30例中牙源性20例,其它10例,5例合并有糖尿病。26例作了脓液细菌培养,15例（57．69％）为阳性。经过切开置管引流、全身支持、大剂量敏感抗生素治疗,治愈23例（76．7％）,死亡7例（23．3％）中6例并发中毒性休克死亡（4例为合并有糖尿病）,1例放弃治疗死于窒息。结论：急性腐败坏死性口底蜂窝织炎病例的诊治关键是早期识别,维持呼吸道通畅,及时切开引流,使用敏感抗生素、有效控制其它伴发疾病、全身对症等综合治疗。重视对并发症的认识及处理,提高临床治愈率。     

口底蜂窝织炎合并纵膈感染3例

口底蜂窝织炎是颌面部严重的感染之一 ,可为化脓性或坏死性 (也称卢德威咽峡炎 )。常起病急 ,病情发展快 ,全身症状严重 ,主要危险是影响呼吸道通畅以及全身中毒 ,如不及时处理 ,可发生窒息或伴发败血症甚至引起纵膈感染而危及患者生命。口底蜂窝织炎引起纵膈感染非常少见。笔者自 1985～1995年 10年间曾遇到 3例典型的病例 ,介绍如下 :　　病例 1:张某某 ,女 ,2 6岁。左下颌后牙疼痛伴口底弥散性肿胀 7ｄ ,曾在当地用青霉素、氨苄青霉素静滴 ,口底切开引流 ,效果不佳。于 1993 0 1 0 2以口底腐败坏死性蜂窝织炎收入我科。入院查 :一般情况…     

口底腐败坏死性蜂窝织炎(40例临床资料分析)

口底腐败坏死性蜂窝织炎是严重的颌面部感染。多发生于小儿,起病急、进展快,全身中毒症状明显,常伴有严重合并症。1981～1984年4年来,我们共收治重症口底腐败坏死性蜂窝织炎40例,约占同期我科住院总人数的3%。现报道如下。     

口底颈胸肩背部广泛腐败坏死性蜂窝织炎并气管食道血管神经受损一例报告

口底颈胸肩背部广泛腐败坏死性蜂窝织炎并气管食道血管神经受损一例报告何一川，杨卫东口底腐败坏死性蜂窝织炎是口腔颌面部死亡率较高、严重感染性疾患之一。作者近期收治一切波及口底，扩散到颈、胸及肩背部广泛腐败坏死佐蜂窝织炎，同时并发口底贯通流涎，气管、食道、...     

用氦氖激光照射血液综合治疗蜂窝织炎

材料和方法 用氦氖激光照射血液综合治疗颌面部蜂窝织炎30例,男18例,女12例。年龄16～60岁。综合治疗包括切开引流,拔除病源牙,解毒、脱敏和抗炎疗     

92例婴幼儿坏死性口底蜂窝织炎临床分析

９２例婴幼儿坏死性口底蜂窝织炎临床分析陈振东，曲文，陈京奕婴幼儿坏死性口底蜂窝组织炎是口腔颌面部严重的急性感染之一，全身症状及局部表现均较成人患者严重，病情发展迅速，常伴有败血症，感染性休克等严重并发症，甚至危及生命。我科自１９８１—１９９４年共收治...     

牙源性蜂窝织炎的综合治疗:用腮腺唾液净化化脓伤口

作者用病人的腮腺唾液透析化脓伤口,因为唾液具有广谱抗菌、蛋白水解和中和作用,一侧腮腺1昼夜能分泌唾液300～400ml。用腮腺唾液灌洗伤口治疗牙源性蜂窝织炎59例,年龄9～50岁。蜂窝织炎定位:颌下间隙21,舌下18,口底6,嚼肌下5,颏下2,腮腺嚼肌间隙5,翼颌间隙2。半数病例炎症波及2～3个间隙。局麻或全麻下切开引流。手术当天或次日在一侧腮腺管内插入导     

拔除下颌第三磨牙致口底凝固坏死性蜂窝织炎一例报告

拔除下颌第三磨牙致口底凝固坏死性蜂窝织炎一例报告新疆伊犁地区人民医院口腔科唐怀璞口底蜂窝织炎系同时波及颌下、颊下及舌下间隙的感染，是颌面部的严重感染之一，它可以是化脓性的、腐败坏死性的，或凝固坏死性的。笔者于１９９２年７月１８日收治一例因拔除右下颌第...     

口底癌34例临床分析

目的探讨口底癌的临床特性、治疗方法及预后。方法对我院自1992—2002年住院治疗的34例口底癌患者进行回顾性分析。结果34例口底癌患者中,男28例(82.4%),女6例(17.6%),男女比为4.7∶1,平均发病年龄58岁。发病部位:前口底22例(64.7%),后口底12例(35.3%)。淋巴结转移率41.2%。单纯手术组、化疗加手术组、放疗加手术组、化疗加手术加放疗组的5年生存率分别为45.5%、60.0%、50.0%、62.5%。结论口底癌以中老年患者好发,男性居多。易发生淋巴结转移,综合疗法疗效较好。     

Role of Ultrasonography in Differentiating Facial Swellings of Odontogenic Origin

IntroductionDifferentiating an acute, odontogenic facial swelling clinically as cellulitis or an abscess has not been thoroughly investigated in endodontics. It has been suggested in the medical and dental literature that the use of ultrasound may aid in differentiating cellulitis from an abscess. Therefore, if ultrasound were more accurate than a blind incision for drainage procedure in locating purulence, perhaps the outcome of the incision for drainage procedure would be beneficial in the resolution of odontogenic infections. The purpose of this prospective study was to compare clinical examination plus ultrasonography versus clinical examination alone in differentiating cellulitis from abscesses in patients with facial swelling of odontogenic origin.MethodsEighty-two emergency patients participated in this study. Each patient was examined and diagnosed by clinical examination and clinical examination plus ultrasonography. An incision for drainage procedure was performed, and a definitive diagnosis was recorded as cellulitis (no purulence) or an abscess (presence of purulence).ResultsWith the incision for drainage procedure, cellulitis occurred 37% of the time and abscesses 63%. With clinical examination alone, a correct diagnosis was made 68% of the time. With clinical examination plus ultrasonography, a correct diagnosis was made 70% of the time. There was no statistically significant difference between the 2 examination methods.ConclusionsThe addition of ultrasonography to a clinical examination did not significantly increase the number of correct diagnoses.     

Facial Candida albicans cellulitis occurring in a patient with oral submucous fibrosis and unknown diabetes mellitus after local corticosteroid injection treatment

Facial cellulitis caused by odontogenic bacterial infection is frequently encountered; however, facial cellulitis caused by Candida albicans infection is rarely found. A patient with oral submucous fibrosis (OSF) and unknown diabetes mellitus (DM) was treated in our out-patient dental clinic by biweekly submucosal injection of 40 mg triamcinolone acetonide into bilateral buccal mucosae plus forced mouth opening performed by the two hands of the clinician. The interincisal distance of the patient improved from 28 to 48 mm after four times of steroid injection. The symptoms and signs of OSF also improved markedly. Unfortunately, facial candidal cellulitis occurred 2 months after the last time of steroid injection treatment. The infection was cured by incision and drainage, intravenous administration of amphotericin B (100 mg once a day for a week), and an appropriate medical control of DM. No recurrence of facial cellulitis was found during the follow-up period of 18 months. To prevent the occurrence of facial cellulitis after a high-dose steroid therapy, some prophylactic procedures should be taken before the initiation of the steroid treatment.     

舌正中岛状瓣修复口底缺损

目的：总结应用舌正中岛状瓣修复口底缺损的经验。方法：5例中小型口底缺损患者采用舌正中岛状瓣修复重建。在舌背正中部位制备舌肌黏膜瓣,通过切开舌尖或舌组织隧道以岛状瓣的方式转移修复口底缺损。结果：5例患者术后舌瓣均成活良好,无舌瓣坏死,1例术后一侧舌尖部分坏死。术后随访3-6个月,患者发音及吞咽功能无明显异常。结论：舌正中岛状瓣是一种修复中小型口底缺损的好方法。     

下颌骨颈胸CT连续扫描在牙源性下行坏死性纵隔炎诊治中的意义

目的:探讨下颌骨颈胸CT连续扫描在牙源性下行坏死性纵隔炎(DNM)诊治中的作用.方法:回顾性总结12例牙源性DNM的临床资料,对其临床表现、治疗及CT诊断结果进行分析.结果:10例可见病灶牙及颌骨变化,下颌颈胸CT连续扫描显示感染自颌面向胸部扩散的连续过程,表现为口底、颌下广泛积气、积脓,经颈部间隙达纵隔,3例为上纵隔感染,9例扩散到下后纵隔;8例伴胸腔积脓、肺部感染,2例心包积脓、积气.结论:牙源性下行坏死性纵隔炎发病急、扩散快、病情凶险、死亡率高,值得警惕.早诊断、早治疗是提高治愈的有效方法.颌面颈胸连续CT扫描是判断感染扩散范围、确定引流部位的有力手段.     

Hematoma following periodontal surgery with a torus reduction: a case report

BACKGROUND: There are no published case reports that hematomas occur on the floor of the mouth as a result of periodontal surgery. REPORT: These three case reports document post surgical hematoma formation on the floor of the mouth that pose problems with the diagnosis, prognosis, and patient management. All cases involved periodontal surgery where extensive reduction of tori and bony exostoses were required. Two cases resulted in hematomas in the floor of the mouth. However, a change in the post surgical management for a third case demonstrated possible prevention of hematoma formation. SUMMARY: Hematomas in the floor of the mouth can be a resolving post surgical phenomenon or a serious vascular insult to this region of the oral cavity. This report clarifies the diagnosis, prognosis, and the best management protocol through the presentation of three cases.     

口腔颌面部多间隙合并颈部及胸腔纵隔感染的回顾性分析

目的探讨口腔颌面部多间隙感染合并颈部及胸腔纵隔感染的诊断、治疗及预后。方法回顾性分析5例口腔颌面部多间隙感染合并颈部及胸腔纵隔感染患者的临床资料,分析其感染来源、临床特点、并发症及处理。结果 5例患者均为牙源性感染,临床表现为颌下、口底、颈部广泛肿胀,脓液形成。影像学显示2例纵隔及胸腔内有脓液形成。经过及时广泛切开引流及多学科综合治疗,4例痊愈,1例死亡。结论对于临床上颌面多间隙感染合并颈部广泛肿胀的病例应予高度重视,影像学检查在早期诊断中有很高价值,应尽早行多部位的切开引流及多学科综合治疗。     

颧骨复合体骨折患者的围术期护理

目的:总结颧骨复合体骨折患者的围术期护理重点和注意事项。方法:对99例颧骨复合体骨折行微型钛板坚强内固定术的患者进行术前心理护理、病情观察、术前准备和术后全麻护理、切口护理、营养护理、开口度康复护理及并发症的观察等。结果:99例颧骨复合体骨折的患者复位及固定效果良好。开口度平均从2.2cm提高到3.9cm。切口一期愈合率达99%。住院期间无患者出现心理障碍。出院时患者对护理的满意度达95%以上。结论:颧骨复合体骨折患者的围术期护理重点是做好心理护理,消除患者恐惧和悲观的心理;伴发颅脑损伤者应严密观察生命指征的变化;开放性骨折患者,要积极止血、抗休克,严格控制切口感染,术后做好切口护理、营养护理及并发症的观察。     

原发灶对侧面动脉黏膜肌皮瓣整复口腔颌面部缺损的临床应用研究

目的 采用原发灶对侧面动脉黏膜肌皮瓣整复舌及口底缺损,丰富口腔颌面部缺损的整复方法。方法 采用6例对侧面动脉黏膜肌皮瓣整复舌及口底肿瘤切除术后缺损。结果 6例原发灶对侧面动脉黏膜肌皮瓣均有足够的血管蒂到达对侧口底舌腹,皮瓣全部成活。所有患者术后均暂时出现面部紧张、张口受限障碍等并发症,3个月后好转,术后半年未见皮瓣缩小。结论 原发灶对侧面动脉黏膜肌皮瓣颜色与舌及口底颜色几乎完全一样,切取简单,成活率高,供区再次损伤畸形小,有望成为舌口底恶性肿瘤切除后即刻修复常规皮瓣。