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目的:分析口腔颌面部间隙感染的临床特点、诊治要点、病原菌的分布情况以及抗生素使用时长的影响因素。方法:回顾性研究四川大学华西口腔医院2009年至2013年收治的463例颌面部间隙感染患者的临床资料,对性别、入院年龄、体温、入院白细胞数、感染来源、是否进行细菌培养、住院时长等数据进行统计学分析。结果:463例患者的年龄为1~82岁,平均年龄47岁;男性265人(57.24%),女性198人(42.76%);大多数患者平均入院体温、入院时白细胞数、入院中性粒细胞百分数均高于正常值。进行分泌物细菌学培养的患者206人(44.49%),在送检的206份标本中,细菌培养结果阳性的有127例,阴性的79例,感染细菌大部分为链球菌属。抗生素使用时长与患者的年龄、抗生素使用种类、细菌培养结果、是否伴有基础疾病等因素均有显著相关性(P<0.05)。结论:患者入院体温、白细胞数、中性粒细胞百分比仍为临床诊治感染的重要指征。及时行脓肿切开引流对控制间隙感染有重要意义;积极进行分泌物细菌培养,对选择正确的抗生素及减少抗生素的使用时长具有指导价值。
OBJECTIVE: To analyze the clinical characteristics, diagnosis and treatment of oral and maxillofacial space infection, the distribution of pathogens and influencing factors of antibiotic use duration. Methods: The clinical data of 463 patients with maxillofacial space infection admitted to Huaxi Stomatological Hospital of Sichuan University from 2009 to 2013 were retrospectively analyzed. The gender, age at admission, body temperature, white blood cell count, source of infection, bacterial culture, hospitalization Duration and other data for statistical analysis. Results: 463 patients were from 1 to 82 years old, with an average age of 47 years. There were 265 men (57.24%) and 198 women (42.76%). Most of the patients had average body temperature, white blood cells at admission, Cell percentages were higher than normal. Of 206 patients (44.49%) who underwent bacterial culture of secretions, 127 were positive for bacterial culture among the 206 samples tested, and 79 were negative. Most of the infected bacteria were Streptococcus. The duration of use of antibiotics was significantly related to the age of patients, the type of antibiotics used, the results of bacterial culture, and the underlying diseases (P <0.05). Conclusion: The body temperature, white blood cell count and neutrophil percentage are still important indications for clinical diagnosis and treatment. Timely abscess incision and drainage of the control gap infection is of great significance; active secretion of bacterial culture, the right choice of antibiotics and reduce the use of antibiotics has a guiding value.