颌面部多间隙感染相关危险因素回顾性临床研究
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摘要
目的探讨分析影响颌面部多间隙感染预后的危险因素。方法将确诊的115例口腔颌面部多间隙感染患者作为研究对象,对其临床资料进行回顾性分析,对病因、临床指标、实验室检查及并发症情况进行分类,同时对造成住院时间延长及并发症的相关因素进行单因素检验及Logistic回归分析。结果病因分类:牙源性41/115(35.65%)、淋巴结炎27/115(23.47%)、唾液腺炎16/115(13.91%)、囊肿16/115(13.91%)、外伤和原因不明15/115(13.04%),其中牙源性感染是最常见的病因。口腔颌面部多间隙感染住院时间≥15d的患者受累间隙数量、白细胞计数、血糖浓度、中性粒细胞百分比均有异于住院时间<15d者,差异有统计学意义(P<0.05);口腔颌面部多间隙感染合并并发症患者年龄、合并全身系统性疾病比例、受累间隙数量、白细胞计数、血糖浓度、中性粒细胞百分比均有异于无并发症的患者,差异有统计学意义(P<0.05)。Logistic回归分析结果显示:口腔颌面部多间隙感染患者住院时间与受累间隙数量、白细胞计数、血糖浓度、中性粒细胞百分比有关;口腔颌面部多间隙感染患者并发症与受累间隙数量、白细胞计数、血糖浓度、中性粒细胞百分比及年龄有关。结论口腔颌面部多间隙感染患者住院时间及并发症的相关危险因素包括合并全身系统性疾病、受累间隙数量、白细胞计数、血糖浓度、中性粒细胞百分比及年龄,上述危险因素均与疾病治疗预后密切相关,临床上对于此类高危人群应高度重视、早期治疗、严密观察,以避免病情发展和恶化。
Objective To explore and analyze the risk factors associated with maxillofacial multiple space infections.Methods A total of 115 patients diagnosed with oral and maxillofacial multiple space infection in our hospital were selected as the research subjects,and the clinical data of those patients was retrospectively analyzed.The etiological factors,clinical presentations,laboratory tests and complications were recorded.At the same time,single factor test and Logistic regression analysis were performed to evaluate the factors that caused the prolongation of hospitalization and complications.Results Incidence and etiological classification:odontogenic41/115(35.65%),lymphadenitis 27/115(23.47%),sialadenitis 16/115(13.91%),cyst 16/115(13.91%),trauma and unknown reason 15/115(13.04%),of which odontogenic infection is the most common cause.The number of spaces involved,the number of leukocytes,the blood glucose concentration,the percentage of neutrophils of patients hospitalized≥ 15 days were different of those of patients hospitalized<15 days,and the differences were statistically significant(P<0.05).The age,associated underlying systemic diseases,the number of spaces involved,the white blood cell count,the blood glucose concentration,percentage of granulocytes in patients with oral and maxillofacial multiple space infection combined with complications were different of those in patients without complications,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the hospitalization time in patients with oral and maxillofacial multiple space infection was related to the number of spaces involved,white blood cell count,blood glucose concentration and neutrophil percentage.The complications of patients with oral and maxillofacial multiple space infections were related to the number of spaces involved,white blood cell counts,blood glucose levels,neutrophil percentage,and age.Conclusion Risk factors associated with hospitalization time and complications in oral and maxillo facial multiple space infections patients included associated underlying systemic diseases,the number of spaces involved,white blood cell count,blood glucose concentration,neutrophil percentage,and age,all the risk factors above were closely related to the prognosis of the disease,Those patients are at higher risk of developing life-threatening complications and require early adequate treatment of their conditions and close clinical monitoring.
Objective To explore and analyze the risk factors associated with maxillofacial multiple space infections.Methods A total of 115 patients diagnosed with oral and maxillofacial multiple space infection in our hospital were selected as the research subjects,and the clinical data of those patients was retrospectively analyzed.The etiological factors,clinical presentations,laboratory tests and complications were recorded.At the same time,single factor test and Logistic regression analysis were performed to evaluate the factors that caused the prolongation of hospitalization and complications.Results Incidence and etiological classification:odontogenic41/115(35.65%),lymphadenitis 27/115(23.47%),sialadenitis 16/115(13.91%),cyst 16/115(13.91%),trauma and unknown reason 15/115(13.04%),of which odontogenic infection is the most common cause.The number of spaces involved,the number of leukocytes,the blood glucose concentration,the percentage of neutrophils of patients hospitalized≥ 15 days were different of those of patients hospitalized<15 days,and the differences were statistically significant(P<0.05).The age,associated underlying systemic diseases,the number of spaces involved,the white blood cell count,the blood glucose concentration,percentage of granulocytes in patients with oral and maxillofacial multiple space infection combined with complications were different of those in patients without complications,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the hospitalization time in patients with oral and maxillofacial multiple space infection was related to the number of spaces involved,white blood cell count,blood glucose concentration and neutrophil percentage.The complications of patients with oral and maxillofacial multiple space infections were related to the number of spaces involved,white blood cell counts,blood glucose levels,neutrophil percentage,and age.Conclusion Risk factors associated with hospitalization time and complications in oral and maxillo facial multiple space infections patients included associated underlying systemic diseases,the number of spaces involved,white blood cell count,blood glucose concentration,neutrophil percentage,and age,all the risk factors above were closely related to the prognosis of the disease,Those patients are at higher risk of developing life-threatening complications and require early adequate treatment of their conditions and close clinical monitoring.
引文
[1]张慧,李晓宇,崔梅花,等.口腔幽门螺杆菌感染对胃内幽门螺杆菌根除疗效的影响及其相关因素研究[J].中国全科医学,2016,19(11):1242,1246.
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[5]吴婉英,杨方英,邵秋月,等.鼻咽癌同步放化疗患者口咽部感染回顾分析与护理对策[J].护理学报,2015,21(3):47-49.
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[7]刘铁军,史婷婷,刘健,等.口腔扁平苔藓患者血清梅毒螺旋体、人类免疫缺陷病毒感染的检测[J].河北医科大学学报,2016,37(1):44-45,53.
[8]郑彩凤.普外科手术切口感染的因素分析及护理对策[J/CD].转化医学电子杂志,2015,2(7):146,147.
[9] Igoumenakis D,Gkinis G,Kostakis G,et al. Severe odontogenic infections:causes of spread and their management[J].Surg Infect(Larchmt),2014,15(1):64-68.
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[11]李宁,张佳更,许乃欣,等.口腔颌面手术全身麻醉术后下呼吸道感染的危险因素分析[J].河北医学,2016,22(12):2080,2083.
[12]童国勇,戈春城,王曦.口腔颌面部间隙感染疗效的影响因素分析[J].临床口腔医学杂志,2016,32(6):366,368.
[13]吴春苏,陈清华.鼻咽癌放疗患者口腔感染的影响因素研究[J].癌症进展,2016,14(5):489,491.
[14] Schuurhuis JM,Stokman MA,Witjes MJ,et al.Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae.A systematic review[J].Oral Oncol,2015,51(3):212-220.
[15]王雯文,白岫峰,胡一帆.80例口腔颌面肿瘤术后感染的影响因素分析及防治措施[J].实用癌症杂志,2017,32(10):1713,1715.
[16]欧洪波,王启晋.口腔颌面外科手术后感染病原菌分布及相关因素分析[J].海南医学,2016,27(8):1329-1330.
[17]田忠奇,刘慧,胡露露,等.口腔颌面部恶性肿瘤患者术后术区感染危险因素分析[J].中国美容医学,2017,26(4):67,70.
[18] Tanio S,Matsushita M,Kuwamoto S,et al.Low prevalence of Merkel cell polyomavirus with low viral loads in oral and maxillofacialtumoursortumour-likelesionsfrom immunocompetentpatients:AbsenceofMerkelcell polyomavirus-associated neoplasms[J]. Mol Clin Oncol,2015,3(6):1301-1306.
[19]何伟,陈欢,陈卫民.口腔颌面外科手术后感染的病原菌分布及感染因素分析[J].口腔颌面外科杂志,2015,25(1):44-46.
[20]邱勋定,廖天安,邓伟,等.口腔颌面部多间隙感染患者院内发生不良结局的相关危险因素分析[J].海南医学,2015,26(18):2707-2710.
[2]郭治辰,龚忠诚,林兆全,等.新疆地区133例口腔颌面部间隙感染临床分析[J].中国口腔颌面外科杂志,2016,14(1):28-32.
[3] Lapthanasupkul P,Juengsomjit R,Klanrit P,et al.Oral and maxillofacial lesions in a Thai pediatric population:a retrospective review from two dental schools[J].J Med Assoc Thai,2015,98(3):291-297.
[4]郑春,王银龙,陈任,等.某省在押HIV感染者/AIDS患者口腔表征的影响因素分析[J].安徽医药,2015,19(7):1286-1289.
[5]吴婉英,杨方英,邵秋月,等.鼻咽癌同步放化疗患者口咽部感染回顾分析与护理对策[J].护理学报,2015,21(3):47-49.
[6]范玉丽,曹征,吴莘,等.48例重症口腔颌面部多间隙感染临床分析[J].中国口腔颌面外科杂志,2015,32(3):249-252.
[7]刘铁军,史婷婷,刘健,等.口腔扁平苔藓患者血清梅毒螺旋体、人类免疫缺陷病毒感染的检测[J].河北医科大学学报,2016,37(1):44-45,53.
[8]郑彩凤.普外科手术切口感染的因素分析及护理对策[J/CD].转化医学电子杂志,2015,2(7):146,147.
[9] Igoumenakis D,Gkinis G,Kostakis G,et al. Severe odontogenic infections:causes of spread and their management[J].Surg Infect(Larchmt),2014,15(1):64-68.
[10]吴伟,潘凌峰,徐斌,等.口腔颌面部多间隙感染患者住院期间不良结局发生的危险因素分析[J].中国全科医学,2017,20(7):75-77.
[11]李宁,张佳更,许乃欣,等.口腔颌面手术全身麻醉术后下呼吸道感染的危险因素分析[J].河北医学,2016,22(12):2080,2083.
[12]童国勇,戈春城,王曦.口腔颌面部间隙感染疗效的影响因素分析[J].临床口腔医学杂志,2016,32(6):366,368.
[13]吴春苏,陈清华.鼻咽癌放疗患者口腔感染的影响因素研究[J].癌症进展,2016,14(5):489,491.
[14] Schuurhuis JM,Stokman MA,Witjes MJ,et al.Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae.A systematic review[J].Oral Oncol,2015,51(3):212-220.
[15]王雯文,白岫峰,胡一帆.80例口腔颌面肿瘤术后感染的影响因素分析及防治措施[J].实用癌症杂志,2017,32(10):1713,1715.
[16]欧洪波,王启晋.口腔颌面外科手术后感染病原菌分布及相关因素分析[J].海南医学,2016,27(8):1329-1330.
[17]田忠奇,刘慧,胡露露,等.口腔颌面部恶性肿瘤患者术后术区感染危险因素分析[J].中国美容医学,2017,26(4):67,70.
[18] Tanio S,Matsushita M,Kuwamoto S,et al.Low prevalence of Merkel cell polyomavirus with low viral loads in oral and maxillofacialtumoursortumour-likelesionsfrom immunocompetentpatients:AbsenceofMerkelcell polyomavirus-associated neoplasms[J]. Mol Clin Oncol,2015,3(6):1301-1306.
[19]何伟,陈欢,陈卫民.口腔颌面外科手术后感染的病原菌分布及感染因素分析[J].口腔颌面外科杂志,2015,25(1):44-46.
[20]邱勋定,廖天安,邓伟,等.口腔颌面部多间隙感染患者院内发生不良结局的相关危险因素分析[J].海南医学,2015,26(18):2707-2710.