新型冠状病毒防控阶段口腔颌面创伤管理策略

新型冠状病毒肺炎（COVID-19）疫情在短期内已扩散至全球30个国家和地区,被世界卫生组织认定为“突发公共卫生事件”。正确的防控措施可以阻断新型冠状病毒在医院内的传播,降低感染发生风险,有效防止疫情的进一步扩散。口腔颅颌面科承担着颌面部创伤急诊的工作,因诊疗操作的特殊性,交叉感染的风险较高,严格的防控措施尤其重要。本文从新型冠状病毒的流行病学特点、患者评估以及门急诊诊疗操作规范、围术期全方位防护管理等方面进行讨论,并提出相应建议。     

新型冠状病毒肺炎疫情下口腔颌面外科的护理防控

新型冠状病毒肺炎的爆发对口腔颌面外科的诊疗和护理带来了巨大的挑战。为有效防止新型冠状病毒肺炎所致的疫情蔓延,最大限度减少新型冠状病毒肺炎在医疗机构内传播的风险,本文结合国家对新型冠状病毒防控的总体要求和颌面外科专业特点,制定口腔颌面外科护理管理相关防控措施,内容涉及预检分诊、分级防护、健康教育、相关科室防控关键点以及护理操作中的防控策略等,以保证颌面外科护理工作有序进行,同时提出了新型冠状病毒肺炎感染防控期间的口腔颌面外科护理管理建议,期望对疫情期口腔颌面外科的护理管理及今后的研究提供参考。     

新型冠状病毒肺炎疫情期口腔颌面外科全身麻醉管理

由于口腔治疗操作的特殊性,治疗过程中会不可避免地产生飞沫和气溶胶等漂浮颗粒,在新型冠状病毒肺炎疫情的防控关键时期内,口腔颌面外科的治疗工作受到很大影响;同时,口腔颌面外科全身麻醉在气道管理过程中极易造成病毒播散,这也为麻醉管理工作带来巨大挑战。本文从专科角度出发,对新型冠状病毒肺炎疫情期口腔颌面外科全身麻醉管理进行论述,以期为疫情期口腔颌面外科全身麻醉实施提供参考。     

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。     

新型冠状病毒肺炎防控时期口腔颌面外科病房诊疗模式的构建与运行

自新型冠状病毒肺炎（COVID-19）疫情爆发以来,中山大学附属口腔医院口腔颌面外科病房从未间断诊疗及护理相关工作。疫情期间,口腔颌面外科医护人员认真学习并严格遵守国家及地区颁布的新型冠状病毒（2019-nCoV）感染疫情防控相关法律法规文件,制定符合疫情防控要求的口腔颌面外科病房诊疗工作模式,有效地开展口腔颌面外科疾病临床治疗及护理工作,从而为口腔颌面部创伤、恶性肿瘤等急危重症患者争取了手术治疗时机。     

新型冠状病毒肺炎疫情期间口腔急诊的管理与防控建议

新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情发展迅速,防控形势严峻。在疫情防控期间,由于口腔诊疗操作的特殊性,如何处理各类口腔急诊,面临着巨大挑战。为了在严密防控疫情的同时,科学有序地做好口腔急诊的临床诊疗工作,本文从人员管理培训、流程及处理、防护和消毒等方面,就新型冠状病毒肺炎疫期口腔急诊处置提出建议,供口腔医疗机构和医务人员参考。     

新型冠状病毒肺炎疫情期间口腔门诊管理与感染防控对策

2019年12月以来,湖北省武汉市新型冠状病毒肺炎（COVID-19,简称新冠肺炎）疫情爆发,并快速向全国各地及境外蔓延,严重威胁人民生命健康。口腔诊疗因具有医护患距离近、操作时间长,并且常规使用高速涡轮快速手机、超声波洁牙机等产生大量飞沫和气溶胶设备的特点,存在较高的院内扩散和医院感染风险。为有效地阻断医院内新型冠状病毒的传播,控制疫情的扩散,结合口腔诊疗特点,本文提出了新冠肺炎疫情期间口腔门诊管理及防控对策,并希望对后疫情期即将恢复正常诊疗活动的医院感染防控提供参考。     

新型冠状病毒肺炎疫情期间对急性牙痛临床诊疗工作的防控建议

当前新型冠状病毒肺炎（COVID-19,简称新冠肺炎）疫情防控形势严峻,口腔诊疗由于其专业特殊性,受到了业界和卫生行政主管部门的关注。那么在疫情防控期间,作为最常见的口腔急症（急性牙痛）应该如何处理？本文结合国家卫生健康委员会颁发的相关规范标准和广东省、广州市卫生健康委员会颁发的口腔门、急诊诊疗工作文件,对疫情期间急性牙痛的处理拟定若干防控建议,以期为临床诊疗提供参考和指引。     

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.     

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％。     

新冠疫情对口腔颌面外科教学模式的影响

目的 :了解并比较口腔医学专业在新型冠状病毒肺炎疫情防控期间在线学习情况,分析在线教学的优势和挑战,为口腔医学教育教学模式的改变提供参考。方法:选择上海交通大学口腔医学院2017级和2018级79名学生作为研究对象,开展在线学习问卷调查。采用SPSS 21.0软件包对数据进行分析。结果:86.08%的同学因疫情防控原因首次接受在线教育;录播和录播+微信群答疑是任课老师多数采用的在线教学形式,分别占51.9%、35.44%;超过70%的同学认为线上教育达到了预期效果,可以应对期末考试。普遍认为(84.28%),增加线上教学可以有效增进理论教学与临床实习的衔接,八年制同学对线上教学的接受程度优于五年制和留学生。结论:线上教学是新型冠状病毒肺炎疫情防控期间维系教学工作的重要途径。正确合理利用信息化技术,将录播、直播和微信答疑群三者结合,可以充分发挥优势,是今后教学改革的可行方向。     

口腔颌面外科手术在新型冠状病毒感染流行期管理的专家意见

由湖北省武汉市首先发现并蔓延至全国乃至世界多个国家的2019新型冠状病毒肺炎（2019-nCoV）主要通过呼吸道飞沫、分泌物或接触传播,具有极强的传染性。口腔颌面外科医师在诊疗过程中,无可避免地需接触患者的口腔、上呼吸道及其他分泌物,极易造成感染,属于高危医务工作者群体。如何提高口腔颌面外科医师的防护意识,在规范或合理建议下开展口腔颌面外科急诊或择期手术的相关工作,是疫情期间亟须解决的问题。为此,口腔颌面外科专业委员会特组织部分专家,撰写了口腔颌面外科手术在新型冠状病毒感染流行期管理的专家建议,为口腔颌面外科临床医师的诊疗提供参考。     

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.     

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。     

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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。