伴全身多系统创伤颌面伤患者的综合救治

目的:研究伴发身体其他部位创伤的颌面伤患者综合救治中专科确定性手术时机和适应证。方法:回顾性统计4所大型综合医院口腔科病房近20年收治的4 869例口腔颌面部创伤患者的临床资料,分析伴发身体其他部位创伤状况和专科手术时机。结果:4 869例患者中,面骨骨折3 364例,软组织伤1 505例。伴发其他部位创伤1 524例(占31.3%),其中颅脑伤570例(37.4%),肢体伤545例(35.8%),胸部伤170例(11.2%),眼创伤151例(9.9%),脊柱伤54例(3.3%),腹部伤34例(2.2%)。74%的颅脑伴发伤患者伤后4周内、76.2%的眼伴发伤患者伤后7d内进行了面骨骨折手术治疗。而肢体、脊柱、胸腹部伴发伤患者,面骨骨折手术均有不同程度延误。结论:伴发多系统创伤的颌面伤患者的救治需要多学科间的合作,在患者呼吸系统、循环系统等全身状况稳定的情况下,大部分颌面多发伤患者可以同期或早期进行专科处理。     

口腔颌面部火器伤机制及创伤救治

本文通过总结口腔颌面部火器伤形成机制和现代创伤学中口腔颌面部分级救治,结合分析战争中卫勤资料,为口腔颌面部火器伤提供救治方案,为我军卫勤力量的人员配置、装备配置提供建议.     

颌骨骨折合并全身损伤的救治

随着现代社会的快速发展 ,颌面部创伤的发病率呈稳步增长的趋势。口腔颌面部损伤常常合并全身其它部位的损伤 ,从而造成多发伤 ;如合并颅脑伤、四肢伤、内脏伤、颈胸部伤等。往往造成伤情复杂各异 ,给救治带来困难。如何处理这类患者 ?是先处理颌面伤 ,还是先处理其它伤等。这已成为口腔颌面损伤救治中的重要课题。作者将近 1 0年中诊治的42例此类患者作一初步小结 ,现报道如下 :1　临床资料本组 :颌骨骨折合并全身其它部位损伤共 42例 ,男性 31例 ,女性 1 1例。最大年龄 67岁 ,最小年龄 1 3岁。合并颅脑伤 1 9例 ,合并四肢伤 1 5例。合并内…     

合并多发伤的口腔颌面骨折47例救治体会

目的: 观察合并多发伤的口腔颌面骨折的救治效果。方法：对47例合并多发伤的口腔颌面骨折患者,在保持呼吸道通畅,保持生命体征稳定的前提下,与相关专科合作,处理颅脑外伤、胸腹外伤、骨盆或长骨骨折等多发伤。处理口腔颌面骨折的重点是在骨折复位后以微型钛板作坚固内固定,辅以颌间固定,坚持术后功能锻炼。结果：47例患者均无严重并发症发生,口腔颌面外伤治愈率为95.74%。结论：合并多发伤的口腔颌面骨折应根据伤情和严重程度决定救治次序,针对不同类型颌面骨折,选择合适的微型钛板作坚固内固定。     

口腔颌面部地震伤的诊治特点及其救治——四川汶川抗震救灾经验与感想

以华西口腔医院参与5.12四川汶川大地震抗震救灾的具体实践为依据,分析口腔颌面部地震伤的诊治特点和救治措施,希望为未来国家应对大规模灾难性事件中口腔颌面部伤的救治提供参考.     

颌面部交通事故伤患者191例的救治

目的 总结口腔颌面部交通事故伤患者救治的要点。方法 回顾分析191例口腔颌面部交通事故伤患者救治的临床资料。结果 本组191例,经过积极抢救,取得良好效果,均获治愈。结论 颌面部交通事故伤患者抢救要多科协作配合,采取综合抢救措施,密切观察病情是提高救治率的重点。?     

口腔颌面部创伤111例患者的伤情分析

目的:总结和探讨"7·23"重特大动车事故发生后一线医院收治的口腔颌面部创伤患者的伤情特点。方法 :对温州市11家医院收治的111例动车事故中口腔颌面部创伤患者的病例资料进行统计和分析。结果:111例口腔颌面部创伤患者中男女比例为1.27∶1;21～30岁(33.3%)为受伤高峰年龄段。在颌面部创伤中,颌面部软组织伤占81.1%,颌面部骨折占11.7%,牙外伤(牙槽突创伤)患者占7.2%。3例下颌骨骨折患者共发生5处骨折,占骨折的29.4%,发生率最高。合并损伤多发,以四肢损伤和胸部损伤最为多见,分别占31.1%和25.7%。结论:动车事故中口腔颌面部创伤多发,但以软组织伤最为常见,颌骨骨折中下颌骨骨折居多;复合伤多,最常见的是四肢和胸部的损伤。     

颌面创伤324例临床分析及救治

本研究分析了 1980年～ 1995年间我科收住颌面创伤患者 32 4例 ,结果表明 :32 4例颌面创伤患者中 ,男性为女性的 3.5倍 ,多发生于青壮年 ,在各类创伤中 ,单纯软组织伤占 18.8% ,骨组织伤占 81.2 % ,多例合并有颅脑、四肢、胸肋等部位损伤以及出现上呼吸道梗阻、休克等严重症状 .本文总结了各类颌面部创伤的治疗原则和处理要点 ,介绍了其救治经验。     

口腔颌面部创伤急救器械的研制

口腔颌面部是人体暴露部位和呼吸道的上端,平时、战时均易受伤.为在战场和事故现场对口腔颌面部战创伤进行快速、有效地抢救和预防窒息,减少颌面部伤残程度和人员的死亡率.经过动物实验和临床应用,济南军区总医院口腔科研制完成4个口腔颌面部战创伤急救专利产品,并与常规救治器材组合成便携式专科急救箱.     

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...     

Medical doctors’ knowledge of dental trauma management: A review

Education in dental trauma is extremely important to promote knowledge on the assessment and management of a traumatized tooth. Medical doctors are normally only required to manage the emergency phase of traumatic dental injury (TDI) treatment before referring to a dentist, endodontist or oral and maxillofacial surgeon for continuing care. Medical doctors who possess sufficient theoretical knowledge and are competent enough clinically to handle TDI can provide a higher standard of treatment care and ultimately achieve a better patient outcome. The aim of this literature review was to assess the extent of medical doctors’ knowledge of dental trauma management for injuries in the following four areas: (a) tooth structure; (b) to the supporting bone; (c) to the periodontal tissues; and (d) to the soft tissues. Based on the findings from this literature review, an overall deficiency in knowledge and confidence in managing dental trauma has been identified. Knowledge and understanding to categorize TDI using the same classification of dental injuries commonly used amongst dentists would allow medical doctors to better manage and communicate with dental colleagues concerning referral for further care. If the medical education curriculum provided medical doctors with more information and skills for the management of dental trauma and an understanding of the importance of early management, then more favourable outcomes may prevail for dental trauma 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。     

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。     

E-scooter injuries referred to the oral and maxillofacial surgical service at Christchurch Hospital: a retrospective observational study and cost analysis of 17-months of data

Personal and shared stand-up electronic scooters (e-scooters) have rapidly increased in popularity, leading to an increase in the number of patients with e-scooter-related trauma presenting to hospital Emergency departments. This study aimed to assess the patterns of oral and maxillofacial trauma directly related to e-scooter use and provide a cost-analysis related to the management of these patients. A retrospective, controlled interval study was conducted to examine all patients referred to the oral and maxillofacial surgical service at Christchurch Hospital, New Zealand, who sustained facial injury as a result of e-scooter accidents between 15 October 2018 and 15 April 2020. A total of 30 patients with e-scooter-related facial injuries were referred to the maxillofacial service and required a total of 23 operative procedures. The majority of patients (70%) were aged between 20-39 years and 63.3% were male. Two-thirds reported having consumed alcohol before the e-scooter accident. The total estimated cost for the treatment of patients was $298,054 NZD. E-scooter-related maxillofacial trauma represents an emerging mechanism of injury that is associated with significant facial trauma and results in a treatment cost that adds significant burden on the health care system.     

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。     

Multidisciplinary management of trauma patients. Role of the maxillofacial surgeon

The approach of patients with multiple trauma is considered to be complicated. Many (non)medical disciplines are involved. This article describes the treatment in the early post-traumatic period and the organisation of the care in both the pre-hospital and hospital phase. Special attention is given to the treatment of patients with maxillofacial injuries. The task of the oral and maxillofacial surgeon in particular when dealing with facial injuries is described.     

年轻恒牙脱位性损伤的诊疗原则

年轻恒牙外伤是影响儿童及青少年牙颌发育与健康的重要疾病，其中脱位性牙外伤常同时累及多颗牙齿和口腔颌面部其他软硬组织，病情复杂，治疗相对困难，远期并发症较多。文章结合2020年国际牙外伤学会颁布的指南，对年轻恒牙脱位性损伤的检查诊断要点、治疗原则和预后进行介绍，为临床儿童牙外伤的诊疗提供参考。