Maxillofacial space infection experience in West China: a retrospective study of 212 cases
Maxillofacial space infection experience in West China: a retrospective study of 212 cases
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西部地区颌面部间隙感染212例回顾性研究
DOI：
10.1016/j.ijid.2009.08.002
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发表时间：
2010-05-01
影响因子：
8.4
通讯作者：
Liang, Xinhua
中科院分区：
文献类型：
--
作者：
Zhang, Chunxu;Tang, Yaling;Liang, Xinhua
目的：我们的目的是分析5年来华西口腔医院收治的颌面部间隙感染（MSI）患者的临床特征，并确定与危及生命的并发症相关的潜在危险因素。方法：进行回顾性病历审查，并对MSI患者的社会人口学和临床特征进行评估。本研究共入组212例患者，其中男性125例（59.0%），女性87例（41.0%），年龄范围1-88岁（中位年龄47.5岁）。牙源性感染是导致MSI的最常见原因（56.1%）。下颌下间隙是最常见的空间，在单间隙和多间隙感染（分别为37.5%和29.1%）。102例患者（48.1%）在入院前自行服药，与未自行服药的患者相比，自症状发作至就诊的时间较长（p = 0.028）。57例患者（26.9%）出现危及生命的并发症，6例死亡（2.8%）。在多变量分析中，发现年龄、自我用药、入院体温、呼吸困难和基础疾病是危及生命的并发症的危险因素。职业以农民最多见（54.7%）。在农民中，72.4%的牙源性病因，但是，91.7%的农民与牙源性间隙感染没有经过牙科治疗前acceptance.Conclusions：我们的经验表明，MSI的管理应更加积极，当存在上述危险因素，以避免危及生命的并发症。此外，考虑到中国西部农村地区医疗条件较差，未来应提供标准的牙科保健和服务，以取代自我药疗。(C)2009年国际传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Our objectives were to analyze the clinical features of maxillofacial space infection (MSI) patients admitted to the West China Hospital of Stomatology over a five-year period, and to identify potential risk factors associated with life-threatening complications.Methods: A retrospective medical chart review was performed and the sociodemographic and clinical characteristics of patients with MSI were evaluated.Results: A total of 212 patients were enrolled in this study, including 125 males (59.0%) and 87 females (41.0%), with an age range of 1-88 years (median 47.5 years). The most common cause of MSI was odontogenic infection (56.1%). The submandibular space was the space most commonly involved in both single space and multiple space infections (37.5% and 29.1%, respectively). One hundred and two patients (48.1%) self-medicated before admission, and the time from onset of symptoms until presentation was longer in those who self-medicated compared with those who did not (p = 0.028). Fifty-seven patients (26.9%) had life-threatening complications and six died (2.8%). In multivariate analysis, age, self-medication, admission temperature, respiratory difficulty, and underlying diseases were found to be risk factors for life-threatening complications. The most common occupation of the patients was farmer (54.7%). Among the farmers, 72.4% had an odontogenic etiology; however, 91.7% of the farmers with odontogenic space infections had not undergone dental treatment before admission.Conclusions: Our experience suggests that the management of MSI should be more aggressive when the above risk factors are present, in order to avoid life-threatening complications. In addition, considering the poor medical conditions in the rural areas of West China, standard dental care and services should be provided in the future to replace self-medication. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.