老年患者颌面部创伤83例临床分析

目的：研究老年口腔颌面部创伤的临床治疗方法及效果。方法：对赤峰学院附属医院口腔科2008年8月至2013年8月期间收治的83例老年口腔颌面部创伤住院病人的病历资料进行统计和分析,并与同期的随机抽取的90例非老年组患者进行比较。结果：83例老年颌面创伤患者男女比例为2.9∶1。交通事故49.39%在致伤原因中居首位。下颌骨骨折发生率最高。在合并伤中,以颅脑损伤6例（42.86%）最多见。经过及时治疗,83例患者生命体征平稳,面部形态恢复满意,咀嚼功能良好,张口度≥3 cm,咬合关系恢复正常。结论：颌面部损伤治疗应以抢救生命,保护功能,恢复面容为原则,及时进行急救和固定处理。     

Management of maxillofacial trauma in prisoners

The incidence of injuries among prisoners is much higher than in the general population, and in the UK the number of prisoners and the incidence of injuries are rising. Maxillofacial trauma is common. Based on the cases of 12 patients, we have identified eight challenges that are associated with the management of maxillofacial trauma in this group: patient-reported mechanisms of injury that are often inconsistent with the fracture pattern, complex fracture patterns, delayed presentation, high prevalence of dental disease and of smoking, complicating medical factors such as drug use and blood-borne viruses, increased risk of further violence after discharge, and problems with follow-up logistics. By actively addressing these challenges we can provide a better service to these patients.     

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1项目简介近年来,我国地震、洪涝等灾害事故多发,安全生产、交通事故死亡人数居世界前列,来自临床的统计结果显示,我国14~40岁人群的最大死因是创伤。创伤现场迅速有效的救治也许能挽回其中许多人的生命,但长期以来,我国缺乏对突发自然灾害及意外事故中受伤人员救治的系统、规范、实用的培训。     

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目的了解儿童颌面创伤发生的原因及危险因素,以提出有效的预防措施。方法对2005年6月至2008年6月东南大学附属南京江北人民医院口腔科就诊的439例儿童颌面创伤病例进行回顾性临床分析,包括年龄、性别、创伤原因、创伤部位、创伤类型等相关因素。结果儿童颌面创伤的发生在年龄、性别、创伤原因、创伤部位、创伤类型方面差异有统计学意义。6～11岁年龄段发生率最高,男孩明显多于女孩,上、下唇及牙齿最易受伤。结论儿童颌面创伤有特定的发病规律,采取针对性有效的预防措施可减少其发生。     

Association between epilepsy and oral maxillofacial trauma: A systematic review and meta‐analysis

A systematic literature search was conducted (through April 2017), using Web of Science, PubMed and Virtual Health Library, manual reference list, and grey literature searches. The quality of the studies was evaluated using the Newcastle‐Ottawa Quality Assessment Scale. The meta‐analysis was performed using R software. A total of 30 studies was included in this review. From a total of 25 studies included in the meta‐analysis, the prevalence of oral and maxillofacial injuries among epileptic subjects was 19%. Among the epileptic patients who suffered some type of injury due to epileptic seizures, 52% had facial soft tissue injuries (95%CI: 28‐75%), 18% suffered dental trauma (95%CI: 11‐29%), and 12% (95%CI: 4‐28%) suffered maxillofacial fractures. Epileptic patients were more likely to have oral and maxillofacial injuries than healthy individuals (OR: 5.22, 95%CI: 2.84‐9.36) and subjects with psychogenic nonepileptic seizures (OR: 2.77, 95%CI: 1.28‐5.99), but not than patients with special needs (OR: 2.45,95%CI: 0.95‐6.31).     

老年口腔颌面部损伤救治320例临床分析

目的:探讨老年口腔颌面部损伤的急救经验。方法:回顾性分析2003年3月-2011年12月我院收治320例62-83岁老年口腔颌面部损伤患者的临床资料。结果:320例老年口腔颌面部损伤患者经抢救及综合治疗,2例患者因重度颅脑损伤及伴心脏疾病抢救无效死亡外,其余均救治成功,治愈率99.4%。2例患者因面部瘢痕明显影响外貌,行二期整形修复,术后恢复满意;109例颌面部骨折术后随访6个月-4年,术后面部形态恢复满意,咀嚼功能良好,张口度≥3 cm,咬合关系恢复正常,X线片显示骨折断端对位良好,未见骨愈合不良、钛板排异反应、伤口感染、神经损伤等并发症。结论:以抢救生命为原则,多科协作,在保障患者生命的前提下,尽早对不同类型的颌面部损伤采取相应的治疗措施,创造手术条件,术中、术后严密监测,发现问题并及时处理,并存心脑血管等系统疾病的老年颌面部损伤患者,能够较顺利的度过围手术期,取得满意的临床效果。     

现代创伤救治理念与口腔颌面部多发伤救治

多发伤的救治需要应用现代创伤救治理念,通过加强多学科间的合作,共同制定救治方案,达到理想的救治效果。本文在了解现代创伤救治理念,理解理念要点的基础上,分析口腔颌面部多发伤救治中伤情评估的策略和方法,探讨专科救治的时机和影响因素,提出伴发身体其他部位损伤的颌面伤患者综合救治中专科确定性手术的时机和适应证,以加深口腔医学专业医生对现代创伤救治理念的理解,提高其对口腔颌面部多发伤的救治能力和治疗效果。     

Massive bleeding following maxillofacial trauma. Case report

A case is reported of massive haemorrhage following severe maxillofacial trauma. The various procedures that were used to control the bleeding are discussed with particular reference to therapeutic arterial embolization.     

Use of patient-reported outcome measures in oral and maxillofacial trauma surgery: a review

In the UK, about one person/100/year sustains a facial injury, so trauma surgery accounts for a considerable part of the caseload in oral and maxillofacial surgery (OMFS). Patient-reported outcome measures (PROM) allow for patient-centred assessment of postoperative outcomes, but to our knowledge, most research in OMFS trauma does not currently include them. To investigate their use, we searched Medline to find relevant studies that reported outcomes from inception in January 1879 to August 2016. Those not in the English language and those that did not report operations were excluded. We retrieved 416 articles, of which 21 met the inclusion criteria (five randomised controlled trials and 16 cohort studies) yielding 16 outcome measures. Most of these had been devised by authors (eight studies), four studies reported use of the Geriatric Oral Health Assessment Index, and three the Nasal Obstruction Symptom Evaluation. Most were used in studies on mandibular surgery (n = 13), followed by those on nasal and facial surgery (n = 3 each). There is a great heterogeneity in the use of these assessments in OMF trauma. In view of their increasing importance compared with simpler objective measures that may not be relevant to the patients’ own perception, more research is needed to establish which of them can be used to measure the QoL of patients treated for OMF trauma.     

口腔颌面创伤后的早期心理测评及心理干预

目的：探讨性格因素对口腔颌面创伤患者心理干预临床效果的影响。方法：采用暴露疗法、催眠等方式,对72例不同程度口腔颌面创伤住院患者进行心理干预．通过SCL-90症状自评清单对患者干预前后的心理状态进行评估,采用SPSS18．0软件包对数据进行统计学分析。结果：干预前,口腔颌面创伤患者SCL-90因子得分普遍高于常模（P〈O．001）．干预后创伤患者的心理健康水平与常模无显著差异。不同创伤严重等级患者心理干预效果差异显著（P〈0．001）,性格因素对干预效果的影响在强迫、人际关系、抑郁和偏执4个因子上差异显著。结论：心理干预的效果与性格因素有关,早期心理干预对内向性格类型的口腔颌面创伤患者的治疗效果优于外向性格类型的患者：创伤严重程度对心理干预的影响与性格因素有关。     

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

The coronavirus disease 2019 (COVID-19) outbreak has had a major impact on medical and surgical activities. A decline in facial trauma incidence was noticed during the lockdown period. The aim of this study was to evaluate the decline in maxillofacial trauma in France during this particular period. A retrospective multicentre comparative study was initiated in 13 major French public hospital centres. The incidence of facial trauma requiring surgery during the first month of lockdown was compared to that during equivalent periods in 2018 and 2019. Differences in the types of trauma were also analysed. Thirteen maxillofacial departments participated in the study. A significant decline in maxillofacial trauma volumes was observed when compared to equivalent periods in 2018 and 2019 (106 patients compared to 318 and 296 patients, respectively), with an average reduction of 65.5% (P = 0.00087). The proportion of trauma due to sports and leisure was reduced when compared to reports in the literature. As a consequence, in the context of a pandemic, the material and human resources related to this activity could be reallocated to the management of other pathologies that cannot be postponed.     

60例老年颌面外伤患者的心理特点及疏导

目的:了解颌面外伤老年患者的心理特点,提出相应的心理疏导对策。方法:选择60例老年颌面外伤住院患者,通过临床观察和语言交流,了解他们不同的心理状态,采取相应的心理疏导措施,观察对老年患者医疗活动所起的意义。结果:通过对老年颌面外伤患者心理状态的了解,使用相应的心理疏导对策,对患者的医疗过程和治疗效果可以起到积极的作用。结论:对老年颌面外伤患者除了积极的医疗救助外,还应进行适当的心理疏导。     

A meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies among children and adolescents

Aims

Children and adolescents who are affected by trauma may have complications that are more serious and dangerous. Herein, a meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies according to the geographic regions of the world among children and adolescents was conducted.

Materials and Methods

A comprehensive search was performed in four databases of PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2006 until July 7, 2021. To evaluate the quality of included articles, an adapted version of the Newcastle-Ottawa scale was used. The prevalence of maxillofacial trauma was estimated by event rates and 95% confidence intervals in relation to etiology and geographic region of study population.

Results

Through search in the databases and the electronic sources, 3071 records were identified, and 58 studies were eligible for inclusion in the meta-analysis. A total of 264,433 maxillofacial trauma cases were reported by all included studies. Globally, the overall prevalence of maxillofacial trauma was highest due to Road Traffic Crashes (RTC) (33.8%) followed by falls (20.7%), violence (9.9%), and sports (8.1%) in children/adolescents. The highest prevalence of maxillofacial trauma were observed in African population (48.3%) while trauma due to falls was most prevalent in Asian population (44.1%). Maxillofacial trauma due to violence (27.6%) and sports (13.3%) were highest in North Americans.

Conclusion

The findings demonstrate that RTC was the most prevalent etiology of maxillofacial trauma in the world. The prevalent causes of maxillofacial trauma differed between the regions of study population.     

儿童口腔颌面部损伤487例临床分析

对487例儿童口腔颌面部损伤的致伤原因、部位、类型以及年龄和性别进行临床分析。男性与女性的比例为1．55：1,5岁以下年龄组患儿所占比例明显高于5岁以上年龄组。跌伤在致伤原因中占70．23％,软组织伤及牙外伤在损伤中分别占64．89％和1129．98％,在软组织损伤中以唇颏部较多,占56．47％。     

数字化技术在口腔颌面部创伤治疗中的应用及展望

口腔颌面部创伤是口腔颌面外科常见疾病,常因颅脑外伤救治或区域医疗技术的限制,可能错过颌面伤的最佳治疗时机,然而,基于牙颌功能和面容外形重建的颌面创伤精准治疗是时代发展的新要求.较为系统的口腔颌面创伤治疗管理始于近代,从最初的简单缝合、夹板固定及钢丝结扎固定,到钛板坚固内固定,再到当前数字化技术辅助下的精准整复治疗,口腔...