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中华口腔医学研究杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 373 -376. doi: 10.3877/cma.j.issn.1674-1366.2020.06.006

所属专题: 经典病例 文献

临床研究

156例颅颌面骨折治疗的临床分析
王科1, 彭国光1,(), 何善志1, 谭玉莲1, 衣利磊2   
  1. 1. 广州中医药大学附属佛山市中医院口腔医疗中心,佛山 528000
    2. 广州中医药大学附属佛山市中医院放射科,佛山 528000
  • 收稿日期:2020-02-19 出版日期:2020-12-01
  • 通信作者: 彭国光

Clinical analysis of 156 patients with craniofacial fracture

Ke Wang1, Guoguang Peng1,(), Shanzhi He1, Yulian Tan1, Lilei Yi2   

  1. 1. Stomatological Medical Center, Foshan Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan 528000, China
    2. Radiological Department, Foshan Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine, Foshan 528000, China
  • Received:2020-02-19 Published:2020-12-01
  • Corresponding author: Guoguang Peng
  • About author:
    Corresponding author: Peng Guoguang, Email:
  • Supported by:
    Medical Scientific Research Foundation of Guangdong Province(B2018193)
引用本文:

王科, 彭国光, 何善志, 谭玉莲, 衣利磊. 156例颅颌面骨折治疗的临床分析[J]. 中华口腔医学研究杂志(电子版), 2020, 14(06): 373-376.

Ke Wang, Guoguang Peng, Shanzhi He, Yulian Tan, Lilei Yi. Clinical analysis of 156 patients with craniofacial fracture[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2020, 14(06): 373-376.

目的

回顾性研究颅颌面骨折患者的治疗方法。

方法

选取佛山市中医院口腔颌面外科2017年1月至2019年12月收治的156例颅颌面骨折患者,经过急诊CT确诊有颅脑外伤并颌面部骨折患者为纳入标准。首先于脑外科处理颅脑外伤,给予护脑、抗炎、脱水等对症处理,病情稳定后手术治疗行颌面部骨折切开复位内固定术,术中麻醉注意保持血压稳定,术后继续脑外科及口腔科专科对症治疗,并康复治疗3 ~ 6个月。

结果

156例颅颌面骨折损伤患者中,16例患者张口受限,9例有面瘫症状,其余患者康复满意。

结论

颅颌面骨折患者治疗应评估好手术时机择期手术,围手术期应密切观察患者颅脑病情变化。

Objective

To study the treatment of cranial-maxillofacial fracture retrospectively.

Method

A total of 156 patients with cranial-maxillofacial fractures were admitted to the Department of Stomatology, Foshan Hospital of Traditional Chinese Medicine from January 2017 to December 2019. All patients with cranial-maxillofacial fractures were confirmed by emergency CT. The patients were treated by neurosurgery for craniocerebral trauma, and given symptomatic treatment such as brain cell protection, anti-inflammatory, dehydration. After the brain condition was stabilized, the patients received surgical treatment, underwent maxillofacial fracture surgical treatment, stable blood pressure maintained by the anesthesiologist. After operation, the patients continued having symptomatic treatment in neurosurgery and stomatology department, and then rehabilitation therapy for 3 to 6 months.

Results

There were 156 patients with cranial-maxillofacial fracture injury, 16 patients with limited mouth opening, 9 patients with facial paralysis, and the rest of the patients recovered satisfactorily.

Conclusions

The treatment of cranial-maxillofacial fractures should be evaluated for stability and then performed operation, and the condition of patients should be closely observed during the perioperative period.

图1 典型病例颧骨复合体骨折术前、后面部照片及CT影像 A:术前面部照;B:术后面部照片;C:术前CT;D:术后CT
[1]
Chrcanovic BR. Factors influencing the incidence of maxillofacial fractures[J]. Oral Maxillofaca Surg,2012,16(1):3-17. DOI:10.1007/s10006-011-0280-y.
[2]
Rivera-Barrios AE, Brown S, Reid CM,et al. Craniofacial fracture patterns in all terrain vehicle injuries[J]. Ann Plast Surg,2015,74 Suppl 4:S229-S230. DOI:10.1097/SAP.0000000000000445.
[3]
Samieirad S, Aboutorabzade MR, Tohidi E,et al. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran:A retrospective study[J]. Med Oral Patol Oral Cir Bucal,2017,22(5):e616-e616. DOI:10.4317/medoral.21809.
[4]
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. DOI:10.1016/j.bjps.2013.10.022.
[5]
Jin KS, Lee H, Sohn JB,et al. Fracture patterns and causes in the craniofacial region:an 8-year review of 2076 patients[J]. Maxillofac Plast Reconstr Surg,2018,40(1):29. DOI:10.1186/s40902-018-0168-y.
[6]
Atisha DM, Burr TV, Allori AC,et al. Facial fractures in the aging population[J]. Plast Reconstr Surg,2016,137(2):587-593. DOI:10.1097/01.prs.0000475791.31361.9a.
[7]
Rotondo MF, Schwab CW, McGonigal MD. "Damage control" :an approach for improved survival in exsanguinating penetrating abdominal trauma[J]. J Trauma,1993,35(3):375-382. DOI:10.1097/00005373-199309000-00008.
[8]
Louis A, Roy I, Dhupar V,et al. Submental intubation in complex maxillofacial trauma:An overview[J]. J Adv Med Dent Sci Res,2015,3(1):66-70.
[9]
Kaiser A, Semanoff A, Christensen L,et al. Submental intubation:an underutilized technique for airway management in patients with panfacial trauma[J]. J Craniofac Surg,2018,29(5):1349-1351. DOI:10.1097/SCS.0000000000004496.
[10]
Lim D, Ma BC, Parumo R,et al. Thirty years of submental intubaion:a review[J]. Int J Oral Maxillofac Surg,2018,47(9):1161-1165. DOI:10.1016/j.ijom.2018.04.015.
[11]
Hassanein AG, Abdel Mabood AM. Can Submandibular Tracheal Intubation Be an Alternative to Tracheotomy During Surgery for Major Maxillofacial Fractures?[J]. J Oral Maxillofac Surg,2017,75(3):508.e1-508.e7. DOI:10.1016/j.joms.2016.10.030.
[12]
Kamra SK, Khandavilli HK, Banerjee P. Submandibular intubation in awake patient of panfacial trauma[J]. Saudi J Anaesth,2016,10(4):446-448. DOI:10.4103/1658-354X.177341.
[13]
Luce EA, Alvarez SM. Submental Intubation[J]. Plast Reconstr Surg Glob Open,2018,6(9):e1896. DOI:10.1097/GOX.0000000000001896.
[14]
Emara TA, El-Anwar MW, Omara TA,et al. Submental intubation versus tracheostomy in maxillofacial fractures[J]. Oral Maxillofac Surg,2019,23(3):337-341. DOI:10.1007/s10006-019-00771-4.
[15]
Malanchuk VO, KoPchak AV. Risk factors for development of infection in patients with mandibular fractures located in the tooth-bearing area[J]. J Craniomaxillofac Surg,2017,35(1):57-62. DOI:10.1016/j.jcms.2006.07.865.
[16]
Varjonen EA, Bensch FV, Pyhältö TT,et al. Remember the Vessels! Craniofacial Fracture Predicts Risk for Blunt Cerebrovascular Injury[J]. J Oral Maxillofac Surg,2018,76(7):1509.e1-1509.e9. DOI:10.1016/j.joms.2018.03.035.
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