面颈部浅层异物残留16例临床分析
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摘要
目的:探讨面颈部浅层异物残留的诊疗措施。方法:回顾性分析2017年1月-2018年10月笔者医院收治的16例面颈部浅层异物患者相关临床资料。统计分析患者人群、异物种类以及致伤因素等,归纳总结颌面部异物诊断、定位方法及手术操作流程,术前均行X线、彩超或CT检查,依据不同位置采取相应治疗措施。结果:面颈部浅层异物以金属类异物为多见,16例患者共取出23块异物,伤口预后均很满意。结论:面颈部浅层异物取出时要注重术前精确定位及切口的隐蔽设计,最大限度地维护面部美观。多普勒超声引导,便于术中快速、准确定位,有助于动态观察异物与周边重要血管的关系,大大提高了异物取出效率。
Objective To explore the diagnosis and treatment of the removal of foreign bodies retained in the maxillofacial and neck area. Methods 16 patients with residual foreign bodies in the maxillofacial and neck area were studied retrospectively in our hospital from January 2017 to October 2018. Patient population, foreign body types and injury factors were described. The treatment measures were taken by the diagnoses and position. Results Metal foreign bodies were the most common in the superficial layer of the maxillofacial and neck area. A total of 23 foreign bodies were taken out from 16 patients, and all patients were satisfied with the surgical results very much. Conclusion The preoperative accurate positioning and good design were very important for removing the superficial foreign bodies. Ultrasound guidance could fix accurately and rapidly on the position of foreign bodies during operation,which helped to dynamically observe the relationship between foreign bodies and important peripheral blood vessels.
Objective To explore the diagnosis and treatment of the removal of foreign bodies retained in the maxillofacial and neck area. Methods 16 patients with residual foreign bodies in the maxillofacial and neck area were studied retrospectively in our hospital from January 2017 to October 2018. Patient population, foreign body types and injury factors were described. The treatment measures were taken by the diagnoses and position. Results Metal foreign bodies were the most common in the superficial layer of the maxillofacial and neck area. A total of 23 foreign bodies were taken out from 16 patients, and all patients were satisfied with the surgical results very much. Conclusion The preoperative accurate positioning and good design were very important for removing the superficial foreign bodies. Ultrasound guidance could fix accurately and rapidly on the position of foreign bodies during operation,which helped to dynamically observe the relationship between foreign bodies and important peripheral blood vessels.
引文
[1]刘梅,孙国文,唐恩溢,等.计算机导航技术在口腔颌面部异物取出手术中的应用[J].口腔医学研究,2017,33(12):1291-1294.
[2]Pattamapaspong N,Srisuwan T,Sivasomboon C,et al.Accuracy of radiography,computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot[J].Radiol Med,2013,118(2):303-310.
[3]Shrestha D,Sharma UK,Mohammad R,et al.The role of ultrasonography in detection and localization of radiolucent foreign body in soft tissues of extremities[J].JNMA J Nepal Med Assoc,2009,48(173):5-9.
[4]郭军,孟庆江,白振西,等.高频超声检查在颌面部非金属异物中的应用价值[J].口腔颌面外科杂志,2004,14(2):133-135.
[5]Javadrashid R,Fouladi DF,Golamian M,et al.Visibility of different foreign bodies in the maxillofacial region using plain radiography,CT,MRI and ultrasonography:an in vitro study[J].Dentomaxillofac Radiol,2015,44(4):20140229.
[6]谢永红,欧阳小鹃,高汉斌,等.CT三维重建技术对面颈部异物定位诊断的临床价值[J].现代诊断与治疗,2015,26(20):4739-4740.
[7]Shokri A,Jamalpour M,Jafariyeh B.Comparison of ultrasonography,magnetic resonance imaging and cone Beam computed tomography for detection of foreign bodies in maxillofacial region[J].J Clin Diagn Res,2017,11(4):TC15-TC19.
[8]Valizadeh S,Pouraliakbar H,Kiani L,et al.Evaluation of visibility of foreign bodies in the maxillofacial region:comparison of computed tomography,cone beam computed tomography,ultrasound and magnetic resonance imaging[J].Iran J Radiol,2016,13(4):e37265.
[9]Eggers G,Mühling J,Hofele C.Clinical use of navigation based on cone-beam computer tomography in maxillofacial surgery[J].Br JOral Maxillofac Surg,2009,47(6):450-454.
[10]冯杭,邢乐君,王丽,等.超声联合CT导航行颅颌面颈部金属异物取出术32例临床分析[J].中国口腔颌面外科杂志,2017,15(3):231-234.
[11]Orlinsky M,Knittel P,Feit T,et al.The comparative accuracy of radiolucent foreign body detection using ultrasonography[J].Am JEmerg Med,2000,18(4):401-403.
[12]Turkcuer I,Atilla R,Topacoglu H,et al.Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?[J].Am J Emerg Med,2006,24(7):763-768.
[13]Xing L,Duan Y,Zhu F,et al.Computed tomography navigation combined with endoscope guidance for the removal of projectiles in the maxillofacial area:a study of 24 patients[J].Int J Oral Maxillofac Surg,2015,44(3):322-328.
[14]张大明,周斌,张善义,等.头颈部严重木竹异物外伤的诊治经验[J].口腔疾病防治,2017,25(12):761-766.
[15]宋光宇.颌面部异物40例临床分析[J].中国民康医学,2013,25(17):59-60.
[2]Pattamapaspong N,Srisuwan T,Sivasomboon C,et al.Accuracy of radiography,computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot[J].Radiol Med,2013,118(2):303-310.
[3]Shrestha D,Sharma UK,Mohammad R,et al.The role of ultrasonography in detection and localization of radiolucent foreign body in soft tissues of extremities[J].JNMA J Nepal Med Assoc,2009,48(173):5-9.
[4]郭军,孟庆江,白振西,等.高频超声检查在颌面部非金属异物中的应用价值[J].口腔颌面外科杂志,2004,14(2):133-135.
[5]Javadrashid R,Fouladi DF,Golamian M,et al.Visibility of different foreign bodies in the maxillofacial region using plain radiography,CT,MRI and ultrasonography:an in vitro study[J].Dentomaxillofac Radiol,2015,44(4):20140229.
[6]谢永红,欧阳小鹃,高汉斌,等.CT三维重建技术对面颈部异物定位诊断的临床价值[J].现代诊断与治疗,2015,26(20):4739-4740.
[7]Shokri A,Jamalpour M,Jafariyeh B.Comparison of ultrasonography,magnetic resonance imaging and cone Beam computed tomography for detection of foreign bodies in maxillofacial region[J].J Clin Diagn Res,2017,11(4):TC15-TC19.
[8]Valizadeh S,Pouraliakbar H,Kiani L,et al.Evaluation of visibility of foreign bodies in the maxillofacial region:comparison of computed tomography,cone beam computed tomography,ultrasound and magnetic resonance imaging[J].Iran J Radiol,2016,13(4):e37265.
[9]Eggers G,Mühling J,Hofele C.Clinical use of navigation based on cone-beam computer tomography in maxillofacial surgery[J].Br JOral Maxillofac Surg,2009,47(6):450-454.
[10]冯杭,邢乐君,王丽,等.超声联合CT导航行颅颌面颈部金属异物取出术32例临床分析[J].中国口腔颌面外科杂志,2017,15(3):231-234.
[11]Orlinsky M,Knittel P,Feit T,et al.The comparative accuracy of radiolucent foreign body detection using ultrasonography[J].Am JEmerg Med,2000,18(4):401-403.
[12]Turkcuer I,Atilla R,Topacoglu H,et al.Do we really need plain and soft-tissue radiographies to detect radiolucent foreign bodies in the ED?[J].Am J Emerg Med,2006,24(7):763-768.
[13]Xing L,Duan Y,Zhu F,et al.Computed tomography navigation combined with endoscope guidance for the removal of projectiles in the maxillofacial area:a study of 24 patients[J].Int J Oral Maxillofac Surg,2015,44(3):322-328.
[14]张大明,周斌,张善义,等.头颈部严重木竹异物外伤的诊治经验[J].口腔疾病防治,2017,25(12):761-766.
[15]宋光宇.颌面部异物40例临床分析[J].中国民康医学,2013,25(17):59-60.