口腔颌面外科手术患者心理卫生状况调查

目的 调查口腔颌面外科手术患者的心理卫生状况，以便提供心理指导。方法 采用症状自评量表(SCL—90)对76例患者进行调查和统计分析。结果 术前躯体化因子分在年龄方面，偏执因子分在文化程度及病种方面有明显差异(P＜0．05)。术后焦虑、敌对以及偏执因子分在病种方面均有明显差异(P＜0．05)。术前术后各因子分的变化量比较显示：躯体化和抑郁因子分的变化量在性别方面，敌对因子分的变化量在职业方面有明显差异(P＜0．05)。术前、术后各因子分之间均无明显差异。结论 口腔颌面外科患者手术前后存在心理卫生问题，并与多种因素相关。医护人员应有针对性地进行围手术期的心理干预。     

DCKS复合麻醉用于口腔颌面外科手术

我院1985年5月～1996年3月采用自制麻醉合剂DCKS(哌替啶D50mg1ml,氯丙嗪C50mg2ml,氯胺酮K200mg4ml,东莨菪碱S0.9mg3ml,复合液共计10ml)用于口腔颌面外科手术麻醉共3548例,麻醉效果满意,现报导如下.     

并存糖尿病的口腔外科手术8例处理报告

近年来，糖尿病的发病率逐年增高，我国的发病率约为２～３％［１］。因此，并存糖尿病的患者接受口腔颌面外科手术的机率也随之增大。治疗过程中处理不当或疏漏将导致发生一系列并发症，直接影响到手术的成功率。我科自１９８８年以来共收治并存糖尿病的口腔颌面外科病人...     

并存糖尿病的口腔外科手术8例处理报告

并存糖尿病的口腔外科手术８例处理报告胡顺广王友山余凤翔近年来，糖尿病的发病率逐年增高，我国的发病率约为２～３％。因此，并存糖尿病的患者接受口腔颌面外科手术的机率也随之增大。治疗过程中处理不当或疏漏将导致发生一系列并发症，直接影响到手术的成功率。我科自...     

70岁以上高龄患者行口腔颌面外科手术的麻醉处理

７０岁以上高龄患者行口腔颌面外科手术的麻醉处理南京市口腔医院麻醉组（２１００８）毛蔚雯，金华瑾临床资料共５０例，男３３例，女１７例。手术种类：口腔颌面部肿瘤４６例，下颌骨放射性骨髓炎２例，下颌骨角化囊肿１例，双颞颌关节脱位１例。术前心血管有病变者２４...     

贺斯人造血浆在口腔颌面外科手术中的应用

外科手术中的血容量 (人造血浆 )补充问题是麻醉科医师的重要课题之一 ,成分输血和血浆代用品的合理联合使用 ,可以达到补充血容量、改善血液循环、增加携氧能力、提高血浆蛋白、增进免疫力和凝血功能、减少并发症的目的。贺斯是中分子羟乙基淀粉 ,属新一代人造血浆代用品。我科自 1999年起将 6 %贺斯用于口腔颌面外科手术病人 ,效果良好安全 ,未发现过敏样反应 ,减少了同种输血的次数及用量 ,节约了手术费用。1　材料与方法术中应用 6 %贺斯的患者为 :ASAI～II级 ,无肾脏病胰腺病变及凝血功能障碍 ;年龄 15～ 6 0岁 ;手术种类不限 ,预计…     

口腔外科手术全麻期间支气管痉挛患者急救处理

以呼吸道压力增加伴呼气性哮喘为特征的通气障碍均称为“支气管痉挛”[1] 。我院 1996～ 1998年共实施全麻手术2 193例 ,其中麻醉期间发生支气管痉挛患者 11例 ,现将其发生的原因及处理措施总结如下。　　作者单位 :43 0 0 79武汉 ,湖北医科大学口腔医学院麻醉科　　一、临床资料1.一般资料 :本组 11例 ,男 4例 ,女 7例 ,年龄 5～ 5 2岁。全部为口腔颌面外科手术患者。2 .麻醉方法 :11例患者的麻醉分别以氯胺酮或异丙酚或硫贲妥钠诱导 ,琥珀胆碱肌松下快速气管插管 ,其中 1例因为双侧关节强直而清醒鼻腔盲探气管插管。以普鲁卡因静点和安氟…     

口腔颌面外科手术全麻后苏醒延迟的临床分析

目的：探讨全麻术后苏醒延迟的原因及临床处理方法。方法：对本院１９９６－１９９８年１１例口腔颌面外科手术全麻后苏醒延迟的原因及临床处理进行了回顾了性分析。结果：苏醒延迟的原因主要有低氧、药物过量,脑外伤及严重电解质紊乱等。临床处理以维持呼吸道通畅、血流动力学稳定为原则,必要时采用脑保护措施,适当应用催醒药。结论：避免苏醒延迟重在预防。对苏醒延迟患者要正确分析原因,对症处理。     

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。     

地氟醚在婴幼儿口腔颌面外科手术麻醉中的应用

地氟醚是一种低效卤化类的新型吸入麻醉剂。二十一世纪 6 0年代末由RossTerrell首先合成 ,1987年开始实验研究 ,1990年进入临床使用阶段。我院从 1999年始 ,将地氟醚用于口腔颌面外科手术的麻醉 313例 ,其中 4岁以下婴幼儿的麻醉 2 10例 ,均取得满意的效果。一、一般资料 :从 2 10例 4岁以下婴幼儿麻醉中 ,随机抽取 6 0例地氟醚麻醉患儿 ,其中男性患儿 38例 ,女性患儿 2 2例 ;年龄最小的是出生后 1个月 ,最大的是 4岁 ,平均年龄 1.88岁 ;体重在5 .0～ 16 .5kg之间 ,平均 11.0 7kg。手术种类 :唇腭裂修复术(包括舌腭弓及舌系带延长术 ) 4 7…     

颌面外科术后疼痛的调查研究

目的：评价颌面部手术后疼痛的发生率、疼痛程度以及与手术类型的关系，为术后疼痛治疗提供临床依据。方法：100例住院手术患者术后24h进行问卷调查，调查术后疼痛程度，对镇痛药物要求度并记录手术类型、年龄、性别和文化程度。结果：100例术后患者，92％为中轻度疼痛，8％为重度疼痛，重度疼痛中以骨折修复较多，多数能够耐受疼痛。结论：颌面外科手术后疼痛多数为中、轻度疼痛，疼痛程度与手术类型有关，骨折类疼痛程度较重，肿瘤类术后疼痛轻。     

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计算机辅助外科是一种基于计算机对大量数据信息的高速处理及控制能力,通过虚拟手术环境为外科医生从技术上提供支援,使手术更安全、更准确的一门新技术。通过运用计算机辅助外科,可以优化手术方案、提供术中实时导航、提高手术的精确性和质量,使外科手术变得更为完美而富于严格的手术程序,从而降低手术危险性。本文主要介绍计算机辅助外科的基本原理、目前在临床上主要涉及的计算机辅助外科相关技术、这些技术的优缺点以及其在1：7腔颌面外科中的应用现状。     

Posterior tibial artery flap versus radial forearm flap in oral cavity reconstruction and donor site morbidity

The repair of soft tissue defects after oral cavity cancer resection is challenging. The aim of this study was to compare the outcomes and donor site morbidity of the radial forearm free flap (RFF) and posterior tibial artery perforator flap (PTAF) for oral cavity reconstruction after cancer ablation. All patients who underwent oral cavity reconstruction with a RFF or PTAF between January 2017 and December 2019 were included retrospectively in this study. All flaps were harvested with a long adipofascial extension. The donor site defects were closed with a triangular full-thickness skin graft harvested adjacent to the flap. Flap outcomes and donor site complications were recorded and compared. The study included 145 patients; 30 underwent reconstruction with a RFF and 115 with a PTAF. No significant difference between the PTAF and RFF was observed concerning the flap survival rate (98.3% vs 96.7%), flap harvest time (53.39 vs 49.28 min), hospital stay (12.3 vs 15.2 days), or subjective functional and cosmetic outcomes. The PTAF showed a larger vascular calibre (P < 0.05), greater flap thickness (P = 0.002), and lower frequency of surgical site infection (P = 0.055) when compared to the RFF. No significant difference was observed between the pre- and postoperative ranges of ankle and wrist movements. The PTAF is an excellent alternative to the RFF for the repair of oral cavity defects, with the additional advantages of a well-hidden scar on the lower extremity, larger vascular calibre, and lower frequencies of postoperative donor site morbidities.     

Comparison between the radial forearm and superficial circumflex iliac artery perforator free flaps for oral soft tissue reconstruction

The radial forearm free flap (RFFF) is widely used for oral reconstruction. The superficial circumflex iliac artery perforator (SCIP) flap is an increasingly utilized alternative. The cases of 165 patients who received either an RFFF or SCIP flap for oral reconstruction at Chris O′Brien Lifehouse, Sydney were reviewed. The aim was to report on patient, pathology, treatment, and outcome variables and to compare these between the two flap groups. A RFFF was used in 126 patients and a SCIP flap in 39 patients. SCIP flap patients were younger (P < 0.001) and had shorter operative times (P < 0.001), shorter anaesthetic times (P < 0.001), and more frequent recipient site dehiscence (P = 0.005) when compared to RFFF patients. The SCIP flap was significantly less frequently used for composite resections including bone when compared to the RFFF (P < 0.001). The primary site distribution was more even for RFFF patients (P < 0.001). There were no SCIP flap failures; three RFFF failures occurred. SCIP flaps performed comparably in terms of operative and clinical outcomes. Most SCIP flaps were utilized in younger patients with partial glossectomy defects.     

Oral rehabilitation of patients after maxillectomy. A systematic review

Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients’ characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient.     

自体输血在口腔颌面外科的应用

近年来,自体输血因可以避免传播传染病、输血差错和免疫反应等同种异体输血相关并发症,而在临床上得到广泛应用。自体输血在口腔颌面外科的应用也逐渐开展起来,作者对自体输血的方法、适应证、禁忌证、并发症以及在口腔颌面外科的应用作一综述。     

混合现实技术在口腔颌面外科的应用进展

混合现实(mixed reality,MR)技术是继虚拟现实和增强现实之后出现的新型全息成像技术,在口腔颌面外科领域得到广泛重视。其技术特点相比于以往的三维可视化技术更具优越性,在手术规划、术中导航、操作训练等方面拥有广阔的发展前景。然而,目前MR技术的临床应用存在局限性,主要体现在医学图像处理系统、图像配准精度、定位系统稳定性、人机交互体验方面,因此突破MR技术瓶颈、改善其临床使用体验,是MR技术在口腔颌面外科领域发展的主要方向。