后疫情时代口腔颌面外科实习教学的思考

新冠(COVID-19)疫情自2019年底爆发以来,已经席卷全球,造成巨大人员伤亡及财产损失.随着各国防控措施有力的执行及各种COVID-19疫苗的面世,COVID-19疫情获得了有效控制.但由于COVID-19病毒的变异及欧美部分国家防控不力,疫情处于起伏状态,短期内很难完全消除病毒,这给口腔临床教学和实习带来一定挑...     

中国口腔颌面外科学科发展调查分析

目的 全面了解中国口腔颌面外科学科发展的现状、发现存在的问题、提出口腔颌面外科可持续发展的策略.方法 设计"口腔颌面外科学科发展问卷调查表",对地市级以上综合医院的口腔科、口腔专科医院、口腔医学院校的口腔颌面外科规模、人力资源、业务范围、医疗工作量、人才培养等项目进行问卷调查,并与5、10年前的状况进行比较.结果 多数医疗机构口腔颌面外科医师人数、病床数、门诊人次增加,业务范围扩大,医疗水平提高.部分基层医疗机构相应医疗指标有下降,超过1/3的医疗机构口腔颌面外科研究生和进修生生源下降.结论 口腔颌面外科在持续发展,但存在基层医疗机构口腔颌面外科力量有所削弱等问题,应采取相应的策略增强学科的竞争力.     

口腔颌面外科麻醉

口腔颌面外科麻醉朱也森１麻醉选择和麻醉特点１．１口腔颌面外科患者的病变部位邻近气道，以气管内插管全身麻醉为常用麻醉方法。麻醉人员术前要做好充分准备，谨慎地选择全麻诱导药物及气管插管方法。１．２麻醉者根据手术需要选择经口或经鼻径路气管插管，上颌骨、上颌...     

中华口腔医学会口腔颌面外科专委会第二届全国口腔颌面肿瘤学术研讨会纪要

经中华口腔医学会批准，由口腔颌面外科专委会肿瘤学组主办、青岛大学医学院承办的第二届全国口腔颌面肿瘤学术研讨会于2003年8月23日～8月27日在山东省青岛市举行。会议受到了中华口腔医学会和口腔颌面外科专委会的指导帮助和与会代表的大力支持。鉴于受非典因素影响及本年度学术会议较多的特点，本次会议采取控制规模、专题讨论的形式，集中对当前口     

《口腔颌面外科杂志》官方微信

等相关信息,并能在线浏览杂志官方网站。欢迎广大口腔医师关注!请扫描下方的二维码,或是搜索公众号“口腔颌面外科杂志”,均可关注到我们!     

西方口腔颌面外科发展简史

西方口腔颌面外科学的发展与解剖学、外科学和牙医学的发展密不可分。本文概述了西方口腔颌面外科学发展的历史,重要人物及贡献、学科和二级专业的形成以及期刊的出现发展等,为广大读者提供参考。     

口腔颌面外科住院患者使用抗生素的调查分析

口腔颌面外科住院患者使用抗生素的调查分析南京大学医学院附属口腔医院（２１００００）吉济华，朱小芹，项贵民兴化市第三人民医院口腔科吉卫华抗生素的“滥用”与不合理使用越来越受到临床工作者的重视，本文通过对南京大学医学院附属口腔医院近年来住院患者抗生素使用...     

要素膳食应用于口腔颌面外科的临床观察

要素膳食(Element diet)是我国近来在营养方面的一项重要发展。目前在我国一些综合性医院已有一些经验。为了探讨要素膳食对口腔颌面外科的临床效果,我们对20例不同病种的住院病人进行临床观察。材料与方法 1、临床资料:收集不同病种20例,男、女各10例。最大年龄66岁,最小7岁,平均24.4岁。分为要     

Approaches to the management of patients in oral and maxillofacial surgery during COVID-19 pandemic

Oral and maxillofacial surgery is correlated with a high risk of SARS-CoV-2 transmission. Therefore, the aim of the review is to collect and discuss aspects of the management of patients in oral and maxillofacial surgery during the COVID-19 pandemic.In order to save resources and to avoid unnecessary exposure to infected patients, there is the need to schedule interventions depending on their priority. During the peak of the pandemic, no elective surgery should be performed. Even urgent procedures might be postponed if there is a view to recovery of a COVID-19 patient within a few days. Emergency procedures do not allow any delay.Specialties with overlap in therapies should have well defined arrangements among each other concerning the treatment spectra in order to avoid redundancy and loss of resources.Inpatient and outpatient units have to be organized in such a way that the risk of cross-infection among patients is reduced to a minimum. Especially, testing of patients for SARS-CoV-2 is important to detect the infected patients at an early stage. When surgery is performed on COVID-19 patients, adequate personal protective equipment is crucial. There must be negative pressure in the operating room, and aerosol formation must be reduced to a minimum.In order to address the COVID-19 challenge adequately, significant changes in the infrastructure of outpatient units, inpatient units, and operating rooms are needed. In addition, the demands concerning personal protective equipment increase significantly. The major aim is to protect patients as well as the medical staff from unnecessary infection, and to keep the healthcare system running effectively. Therefore, every effort should be taken to make the necessary investments.     

新型冠状病毒肺炎疫情下25例口腔颌面外科急诊患者临床分析

目的:总结分析在新型冠状病毒肺炎（COVID-19）流行期间,第四军医大学口腔医院口腔颌面外科收治的急诊患者情况、收治流程、手术方法与感染防控措施,为制订COVID-19流行期间的口腔颌面外科急诊治疗规范提供参考。方法:收集2020年1月23日—2月20日第四军医大学口腔医院口腔颌面外科收治的所有急诊病例,对患者情况进行统计分析,包括患者性别与年龄、疾病种类、致病原因、手术时间等,并探讨流行病学特点和意义,疫情期间口腔颌面外科急诊处置流程与手术要点。结果:疫情期间,口腔颌面外科共收治25例急诊患者,其中男10例,女15例;≥18岁13例,<18岁12例;颌面部挫裂伤11例,下颌骨骨折10例,间隙感染4例。24例患者行手术治疗,5例在病房治疗室局麻下行清创缝合术,医护人员按二级防护级别操作;其余19例均在负压手术室内完成手术,医护人员按三级防护操作。所有患者均成功治疗,诊疗期间未发生COVID-19感染。结论:COVID-19疫情期间,口腔颌面外科急诊以外伤为主,意外摔伤是主要致伤因素,儿童和女性急诊患者比例较大;交通事故是造成颌骨骨折的主要原因。收治口腔颌面急诊患者时,应注重采取防护措施。在仔细评估伤情、遵守治疗原则的基础上,可简化手术操作,缩短手术时间。口腔颌面外科医师应与感控专家和医院管理层建立顺畅的联系,尽可能降低COVID-19感染风险。     

Impact of COVID-19 on maxillofacial surgery practice: a worldwide survey

The outbreak of coronavirus disease 2019 (COVID-19) is rapidly changing our habits. To date, April 12, 2020, the virus has reached 209 nations, affecting 1.8 million people and causing more than 110,000 deaths. Maxillofacial surgery represents an example of a specialty that has had to adapt to this outbreak, because of the subspecialties of oncology and traumatology. The aim of this study was to examine the effect of this outbreak on the specialty of maxillofacial surgery and how the current situation is being managed on a worldwide scale. To achieve this goal, the authors developed an anonymous questionnaire which was posted on the internet and also sent to maxillofacial surgeons around the globe using membership lists from various subspecialty associations. The questionnaire asked for information about the COVID-19 situation in the respondent’s country and in their workplace, and what changes they were facing in their practices in light of the outbreak. The objective was not only to collect and analyse data, but also to highlight what the specialty is facing and how it is handling the situation, in the hope that this information will be useful as a reference in the future, not only for this specialty, but also for others, should COVID-19 or a similar global threat arise again.     

The scope of oral and maxillofacial surgery in Australia and New Zealand. A postal survey

The current scope of oral and maxillofacial surgery in Australia and New Zealand was explored with a survey of full members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons resident in the region. There was an 83 per cent usable response rate and the objectivity of the data was confirmed by check questions and material from other sources. The study showed that oral and maxillofacial surgery is the surgical specialty of dentistry with the core of referral and surgical services being dento-alveolar. However, the essential knowledge of the anatomy, pathology, and surgery of the orofacial region forms the basis for the wider scope of modern oral and maxillofacial surgery. Current surgery includes management of trauma, pathology, dentofacial deformity, and a wide range of reconstructive surgery including grafts and implants.     

德国口腔颌面肿瘤外科临床技术管窥

介绍作者在德国工作期间所见德国口腔颌面肿瘤外科技术和经验,并将德国经验与国内做法进行比较,分析了德国经验的优点.     

An update on the current training situation of German interns in oral and maxillofacial surgery at special times in 2021

The aim of this study was to evaluate the current state of training of German interns in oral and maxillofacial surgery (OMFS) under the influence of the COVID-19 pandemic in 2021.A previously tested questionnaire consisting of 53 questions was sent to interns in German OMFS (non-) university hospitals and private practices as an online survey. The questionnaire was adapted to current topics, such as the ongoing COVID-19 pandemic, aspects concerning nighttime and weekend services, overtime hours, surgical logbooks, benefits of academic degrees and support for scientific activities, part-time employment, parental leave and childcare. Next, results of questions from before the COVID-19 pandemic were re-evaluated.The COVID-19 pandemic influenced the clinical work (71.83%) and the current state of training (68.64%) in OMFS of most participants. Nighttime and weekend services are possible for employees in possession of only one degree (87.93% with a medical degree) in most hospitals. Not having one or both doctorate degrees was considered to be a disadvantage by 54.95%. In all, 42.11% of the participants attested to a positive influence of research on their training situation, and 50% reported financial or non-financial research support from the employer. Part-time employment was possible for 78.81% of the participants. The course of training was interrupted more often for women due to parental or maternity leave (10.53% of men and 30.95% of women). A total of 40.71% of the participants reported that childcare was available at the hospital, theoretically.The state of OMFS training in Germany can be referred to as positive. Current and future challenges are diverse, including aspects originating from the ongoing COVID-19 pandemic, gender aspects, reconciliation of family and work, and flexible working hours. Addressing these topics will ensure OMFS training at the highest surgical level and further increase interns’ satisfaction, preserving the specialty’s popularity and reception.     

Educational paper: research in oral and maxillofacial surgery

Training in oral and maxillofacial surgery (OMFS) requires undergraduate degrees in both medicine and dentistry. When trainees in other surgical specialties may be pursuing a higher degree in research or education, OMFS trainees will be studying for their second undergraduate degree. It is possibly therefore that the specialty is weak in terms of doubly qualified university academics who have been trained in the full and extended curriculum OMFS. Research is recognised in all applications to United Kingdom and Ireland specialist training programmes, and points are awarded, though many juniors who enter these will have found it difficult to do any research during their careers to date. With changes in specialist training it may become even more difficult to obtain a research degree, although with the introduction of the National Institute for Health Research Integrated Academic Training (academic clinical fellowships/clinical lectureships) there is renewed hope that enthusiasm for academic OMFS will be reignited. In this paper we try to provide an idea of the opportunities available to OMFS trainees in academia and research.     

Management in oral and maxillofacial surgery during the COVID-19 pandemic: Our experience

A novel β-coronavirus (2019-nCOV), identified in Wuhan City in late December 2019, is generating a rapid and tragic health emergency in Italy due to the need to provide assistance to an uncontrollable number of infected patients and, at the same time, treat all the non-deferrable oncological and traumatic maxillofacial conditions. This article summarises the clinical and surgical experience of Maxillofacial Surgery Unit of “Magna Graecia” University (Catanzaro -Italy) during the COVID-19 pandemic and would like to provide a number of recommendations that should facilitate the scheduling process of surgical activities during the COVID-19 pandemic and reduce the risk of infection among healthcare professionals.     

新型冠状病毒肺炎疫情期间口腔颌面创伤门急诊护理策略

新型冠状病毒肺炎（COVID-19）疫情目前仍然处于严峻阶段。由于口腔颌面创伤处理的特殊性及紧迫性,门急诊创伤工作医务人员承担着潜在的感染风险,切实有效落实防控措施尤为重要。护理工作在整个口腔颌面创伤的诊救过程中扮演着相当重要的角色。如何协同团队,在积极应对急症的情况下,正确落实各项防控措施,阻断疫情扩散,从而降低感染发生的风险,是目前护理工作需要面临的重要问题。本文以上海交通大学医学院附属第九人民医院口腔颌面门急诊创伤护理工作经验为例,初步讨论了口腔颌面门急诊创伤护理策略,旨在为临床开展工作提供参考。     

保留气管插管在口腔颌面外科中的意义

目的探讨气管插管术在口腔颌面外科手术后气道安全维护中的作用,以及与气管切开术比较之优越性. 方法临床分析49例口腔颌面外科病例,实施气管插管术48例,插管期间应用镇静镇痛治疗使病人Ramsay评分维持在2-4级,观察插管留置时间、留置期间血气(SpO2),气管插管保留或拔除后有无手术部位出血、血肿及肺部感染等并发症.结果气管插管平均留置时间为1.56±0.74天,留置期间SpO2>98%(99.76±0.52%)所有气管插管病人无气道损伤,无气道出血,无肺部感染及镇静药物应用后呼吸抑制发生.结论在现代口腔颌面部手术治疗中,气管插管术不仅保障病人呼吸道通畅,对手术的成功起着十分重要的作用,而且具有损伤小,并发症少,减少了病人痛苦,缩短术后恢复时间,提高了病人的生存质量等优势.