喀什地区1 115例颌面部骨折的回顾性分析
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摘要
目的探讨喀什地区颌面部骨折患者的临床流行病学特点和治疗方法,为临床诊疗提供参考。方法对喀什地区第一人民医院2011年11月至2016年11月收治的1 115例颌面部骨折患者的临床资料进行回顾性分析,包括年龄构成、性别比例、创伤原因、好发时间、损伤部位、全身伴发损伤等。结果 1 115例颌面部骨折中,男女比例为4.7∶1,21～30岁为好发年龄段,多发生于夏季(31.38%)、春季(29.69%),创伤原因中高处坠落伤最多(38.57%),交通伤其次(36.95%);骨折部位以面中部骨折多发(65.38%),下颌骨骨折次之(30.26%);42.15%的病例合并全身损伤,其中眼部损伤最多(35.55%),其次是四肢损伤(21.67%),大部分患者(50.04%)选择切开复位内固定术。对面中部骨折进行Logistics回归分析表明男性较女性更易发面中部骨折,高龄患者更易发生面中部骨折。结论喀什地区颌面部骨折患者男性多于女性,青壮年占绝大多数,春夏季是发病高峰期,高处坠落伤及交通伤是主要病因,骨折部位以面中部骨折较多见,合并损伤中以眼部损伤最为常见,治疗方式多以切开复位内固定为主,面中部骨折的发生与患者年龄、性别及创伤原因关系密切。
Objective To explore the clinical epidemiological characteristics and treatment methods of maxillofacial fracture patients in the Kashgar Prefecture to provide a reference for clinical diagnosis and treatment. Methods The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications. Results Among the 1 115 patients, the ratio of males to females was4.7∶1, and those aged 21 to 30 years accounted for the majority of patients, with most injuries occurring in the summer(31.38%) and spring(29.69%). The most common cause of trauma was falling(38.57%), followed by traffic accidents(36.95%). Midfacial fractures were the most frequently observed(65.38%), followed by mandibular fractures(30.26%).In all, 42.15% of cases were complicated with systemic injuries, the majority being ocular injuries(35.55%), followed by limb injuries(21.67%). The majority of patients(50.04%) chose treatment by open reduction and internal fixation.Logistic regression analysis showed that males were more prone to midfacial fractures than females. The occurrence of midfacial fracture became more likely with increasing age. Conclusion In the Kashgar Prefecture, the majority of patients with maxillofacial fracture are male and young or middleaged. Most maxillofacial fractures occur in the spring or summer and are mainly caused by falling or traffic accidents. Fractures in the middle part of the face are more common.Ocular injury is the most common complication, and in most cases, the fracture is treated by open reduction and internal fixation. The occurrence of midfacial fracture is closely related to age, sex and cause of trauma.
Objective To explore the clinical epidemiological characteristics and treatment methods of maxillofacial fracture patients in the Kashgar Prefecture to provide a reference for clinical diagnosis and treatment. Methods The medical records of 1 115 patients with maxillofacial fracture admitted to the First People's Hospital of Kashgar from November 2011 to November 2016 were retrospectively analyzed by age composition, sex ratio, cause of trauma, time of injury, site of injury and systemic complications. Results Among the 1 115 patients, the ratio of males to females was4.7∶1, and those aged 21 to 30 years accounted for the majority of patients, with most injuries occurring in the summer(31.38%) and spring(29.69%). The most common cause of trauma was falling(38.57%), followed by traffic accidents(36.95%). Midfacial fractures were the most frequently observed(65.38%), followed by mandibular fractures(30.26%).In all, 42.15% of cases were complicated with systemic injuries, the majority being ocular injuries(35.55%), followed by limb injuries(21.67%). The majority of patients(50.04%) chose treatment by open reduction and internal fixation.Logistic regression analysis showed that males were more prone to midfacial fractures than females. The occurrence of midfacial fracture became more likely with increasing age. Conclusion In the Kashgar Prefecture, the majority of patients with maxillofacial fracture are male and young or middleaged. Most maxillofacial fractures occur in the spring or summer and are mainly caused by falling or traffic accidents. Fractures in the middle part of the face are more common.Ocular injury is the most common complication, and in most cases, the fracture is treated by open reduction and internal fixation. The occurrence of midfacial fracture is closely related to age, sex and cause of trauma.
引文
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[10]Zhou HH,Lv K,Yang RT,et al.Clinical,retrospective case-control study on the mechanics of obstacle in mouth opening and malocclusion in patients with maxillofacial fractures[J].Sci Rep,2018,8(1):1-8.
[11]王科,彭国光,谭玉莲,等.3050例颌面部损伤临床分析[J].口腔疾病防治,2016,24(12):715-719.
[12]Abosadegh MM,Rahman SA,Saddki N.Association of traumatic head injuries and maxillofacial fractures:a retrospective study[J].Dental Traumatol,2017,33(5):369-374.
[13]Gassner R,Tuli T,Hachl O,et al.Cranio-maxillofacial trauma:a10 year review of 9543 cases with 21067 injuries[J].J Craniomaxillofac Surg,2003,31(1):51-61.
[14]Islam S,Gupta B,Taylor CJ,et al.Equine-associated maxillofacial injuries:retrospective 5-year analysis[J].Br J Oral Maxillofac Surg,2014,52(2):124-127.
[15]Mijiti A,Ling W,Tuerdi MA,et al.Epidemiological analysis of maxillofacial fractures treated at a university hospital,Xinjiang,China:a 5-year retrospective study[J].J Craniomaxillofac Surg,2014,42(3):227-233.
[2]Manodh P,Shankar DP,Pradeep D,et al.Incidence and patterns of maxillofacial trauma-a retrospective analysis of 3611 patientsan update[J].Oral Maxillofac Surg,2016,20(4):1-7.
[3]O′meara C,Witherspoon R,Hapangama N,et al.Alcohol and interpersonal violence may increase the severity of facial fracture[J].Br J Oral Maxillofac Sur,2012,50(1):36-40.
[4]高向东,朱蓓倩,杨胜利.西部少数民族聚居地区人口新特征及发展趋势--以新疆喀什地区为例[J].人口与发展,2013,19(3):38-45,54.
[5]Cabalag MS,Wasiak J,Andrew NE,et al.Epidemiology and management of maxillofacial fractures in an Australian trauma centre[J].J Plast Reconstr Aesthet Surg,2014,67(2):183-189.
[6]Thoren H,Iso-Kungas P,Iizuka T,et al.Changing trends in causes and patterns of facial fractures in children[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol,2009,107(3):318-324.
[7]Pandey S,Roychoudhury A,Bhutia O,et al.Study of the pattern of maxillofacial fractures seen at a tertiary care hospital in North India[J].J Maxillofac Oral Surg,2015,14(1):32-39.
[8]Ki-Su J,Ho L,Jun-Bae S,et al.Fracture patterns and causes in the craniofacial region:an 8-year review of 2076 patients[J].Maxillofac Plast Reconstr Surg,2018,40(29):3-11.
[9]陈晨,杨尧,巩玺,等.口腔颌面部新鲜骨折1009例回顾分析[J].中华口腔医学杂志,2015,50(11):650-655.
[10]Zhou HH,Lv K,Yang RT,et al.Clinical,retrospective case-control study on the mechanics of obstacle in mouth opening and malocclusion in patients with maxillofacial fractures[J].Sci Rep,2018,8(1):1-8.
[11]王科,彭国光,谭玉莲,等.3050例颌面部损伤临床分析[J].口腔疾病防治,2016,24(12):715-719.
[12]Abosadegh MM,Rahman SA,Saddki N.Association of traumatic head injuries and maxillofacial fractures:a retrospective study[J].Dental Traumatol,2017,33(5):369-374.
[13]Gassner R,Tuli T,Hachl O,et al.Cranio-maxillofacial trauma:a10 year review of 9543 cases with 21067 injuries[J].J Craniomaxillofac Surg,2003,31(1):51-61.
[14]Islam S,Gupta B,Taylor CJ,et al.Equine-associated maxillofacial injuries:retrospective 5-year analysis[J].Br J Oral Maxillofac Surg,2014,52(2):124-127.
[15]Mijiti A,Ling W,Tuerdi MA,et al.Epidemiological analysis of maxillofacial fractures treated at a university hospital,Xinjiang,China:a 5-year retrospective study[J].J Craniomaxillofac Surg,2014,42(3):227-233.