本文基于检索PubMed、Embase、Web of Science、Cochrane Library及中国知网等数据库中2004—2025年发表的相关文献，并结合现行指南、专家共识及代表性临床研究，构建出以生理-炎症轴为核心的口腔颌面多间隙感染（OMSI）四域整合框架，用于辅助重症OMSI的风险分层与路径化管理，从生理失代偿、感染范围与解剖累及、炎症反应和宿主储备4个维度进行归纳分析。重症OMSI的风险评判非取决于单一指标。本文提出的生理-炎症轴四域整合框架对临床信息采取加权整合，其中生理失代偿、感染范围与解剖累及直接决定早期救治的紧迫性，炎症反应和宿主储备则用于判断感染活动性、治疗反应及患者对感染、麻醉和手术等干预的耐受能力。同时以入院后时间（t）的关键时间窗为节点进行路径化管理：0 h<t≤1 h完成气道评估与初始复苏，1 h<t≤6 h落实切开引流与感染源控制，6 h<t≤24 h强化多系统监测，24 h<t≤48 h进行首次系统复评，t>48 h根据病情实施降阶梯治疗、康复与随访。该框架将重症OMSI的危险因素识别、床旁评估、风险分层和多学科协作纳入同一决策链，有助于临床早期识别高危患者并组织路径化处置。目前该框架仍属于探索性架构，各项指标的权重、阈值及临床适用边界尚需通过多中心前瞻性研究进一步验证和完善。

Based on a review of relevant literature published between 2004 and 2025 in PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure, together with current guidelines, expert consensus statements, and representative clinical studies, this article proposes a four-domain integrated framework for oral and maxillofacial multispace infection (OMSI) centered on the physiology-inflammation axis. The framework is intended to support risk stratification and pathway-oriented management of severe OMSI by integrating evidence across four domains: Physiological decompensation, infection extent and anatomical involvement, inflammatory response, and host reserve. Risk assessment of severe OMSI should not depend on any single indicator. The proposed physiology-inflammation axis-based framework applies weighted integration of clinical information, in which physiological decompensation and infection extent with anatomical involvement directly determine the urgency of early intervention, whereas inflammatory response and host reserve are used to assess infection activity, treatment response, and the patient's tolerance of infection, anesthesia, surgery, and other interventions. Pathway-oriented management is organized around key time windows: Airway assessment and initial resuscitation at 0 h<t≤1 h, incision and drainage with source control at 1 h<t≤6 h, intensified multisystem monitoring at 6 h<t≤24 h, the first systematic reassessment at 24 h<t≤48 h, and de-escalation, rehabilitation, and follow-up at t>48 h according to the patient's clinical condition. By incorporating risk-factor identification, bedside assessment, risk stratification, and multidisciplinary collaboration into a unified decision-making pathway, the framework may facilitate the early identification of high-risk patients and the organization of structured clinical management. At present, the framework remains exploratory, and the weighting of individual indicators, threshold settings, and boundaries of clinical applicability require further validation and refinement through multicenter prospective studies.