牙周干预治疗降低口腔颌面部肿瘤患者术后的下呼吸道感染

目的 通过纵向干预实验,探讨牙周感染是否为口腔颌面部肿瘤患者术后发生下呼吸道感染的风险因素.方法 选取2012年1月～2016年12月在我院接受口腔颌面部肿瘤手术治疗并伴有慢性牙周炎的患者,随机均分为两组,实验组24h内完成一次性牙周干预治疗;对照组给予2周复方氯己定含漱液含漱,两组患者在接受牙周治疗后进行口腔颌面部肿瘤手术.统计学分析牙周干预治疗6周后,两组的临床指标以及下呼吸道感染发生率的差异.结果 实验组在治疗6周后菌斑指数(PLI)、探诊出血指数(BOP)、牙周袋探诊深度(PPD)和临床附着丧失水平(CAL)低于对照组,牙龈退缩水平(GR)数值高于对照组,牙周炎症的控制和好转优于对照组,P＜0.01.对照组PLI、BOP、PPD数值下降,GR和CAL数值与基线水平组间均数差异无统计学意义,P＞0.05.实验组下呼吸道感染的发生率为2.22％,低于对照组的发生率7.11％,P＜0.01.实验组的咳嗽、咳痰以及症状发生率合计低于对照组,P＜0.01.结论 牙周感染是口腔颌面部肿瘤患者术后发生下呼吸道感染的相关因素之一.牙周干预治疗能够有效控制和改善牙周状况,降低该类患者手术后下呼吸道感染的发病率,以及咳嗽和咳痰等临床症状的发生率,临床效果优于传统的复方氯己定含漱液含漱方法.

Prior periodontal intervention lowers incidence of lower respiratory infection in patients receiving oral and maxillofacial tumor surgery

Objective To investigate whether periodontal infection is a risk factor for lower respiratory infection patients receiving oral and maxillofacial tumor surgery.Methods Patients undergoing oral and maxillofacial surgery for tumors with concurrent periodontal disease between January,2012 and December,2016 were randomized into periodontal intervention group and control group (treated with gargle solution containing chlorhexidine gluconate).The one-time periodontal intervention was completed within 24 h in the intervention group and two-week mouthwash was prescribed in the control group before oral and maxillofacial tumor surgery.Five periodontal indexes were examined at baseline and at 6 weeks after the treatment.The clinical symptoms and incidence of lower respiratory infections were compared between the two groups at 6 weeks.Results The PLI,BOP,PPD,and CAL were significantly lower and GR was higher in the intervention group than in the control group (P＜0.01).The periodontal status was sigrtificantly improved in the intervention group.The incidence of lower respiratory infection was significantly lower in the intervention group than in the control group (2.22％ vs 7.11％,P＜0.01).The incidences of cough and expectoration in the intervention group were significantly lower than those in control group (P＜ 0.01).Conclusions Periodontal infection is one of the risk factors for lower respiratory infection after oral and maxillofacial tumor surgery.The periodontal status can be effectively controlled and improved by periodontal intervention.Compared with mouthwash,periodontal intervention can significantly reduce the incidences of cough and expectoration and lower the incidence of lower respiratory infections.