Abstract:

Objective    To analyze the characteristics of oral and maxillofacial space infection and the clinical differences between different patients，and to explore the targeted therapy.  Methods    Totally 380 patients with oral and maxillofacial space infection in First Hospital of Shanxi Medical University from January 2011 to November 2016 were selected. Retrospectively analyze pathogenic site，source of infection，bacterial infection and clinical efficiency. Patients were divided into diabetic group and elderly group，and their clinical features of disease were analyzed. SPSS17.0 software was used for statistical analysis. Results    Submandibular space accounted for 26.05% of the single-space infection，masseteric and infraorbital space accounted respectively for 12.11% and 11.05%；odontogenic infection accounted for 68.16%；Staphylococcus  aureus accounted for 31.22%，and Pseudomonas  aeruginosa  accounted  for 28.08%；total effective rate of treatment was 98.95%； fasting blood glucose，hospital stay，multiple space infection and complication had significant difference between diabetic group and non- diabetic group（P < 0.05）；hospital stay，multiple space infection and complication had significant difference between elderly group and control group（P < 0.05）. Conclusion    Oral and maxillofacial space infection are mostly odontogenic；elderly and diabetic group have longer hospital stay and higher incidence  rate of multiple space infection and complication，and their state of illness tend to be severer；not  only are antibiotics  and  surgery used for clinical treatment，but glycemic control  and actively systemic support treatment should be performed，which can improve physical  fitness and promote healing.

Key words: oral and maxillofacial region, space infection, diabetes, elderly, treatment

摘要：

目的    分析口腔颌面部间隙感染（maxillofacial space infection，MSI）的一般特征及不同患者群体间的临床差异，并探讨治疗方法的针对性。方法    选取2011年1月至2016年11月山西医科大学第一临床医院收治的符合纳入标准的380例MSI患者，回顾性分析其感染部位、感染来源、感染病原菌和治疗有效率；按照是否合并糖尿病及年龄因素分别分析糖尿病组和老年组的临床疾病特征。数据结果均采用SPSS17.0软件进行统计分析。 结果    单一间隙感染部位中颌下间隙占26.05%，咬肌间隙和眶下间隙分别占12.11%和11.05%；牙源性感染占68.16%；检出革兰阳性菌中金黄色葡萄球菌占31.22%，革兰阴性菌中铜绿假单胞菌占28.08%；治疗总有效率为98.95%；糖尿病组和非糖尿病组在空腹血糖、住院天数、多间隙感染、并发症等指标间的差异均有统计学意义（P＜0.05）；老年组和非老年组在住院天数、多间隙感染、并发症等指标间的差异均有统计学意义（P＜0.05）。结论    MSI以牙源性为主；老年患者和合并糖尿病者住院天数更长，多间隙感染及并发症的发生率更高，病情发展往往更严重；在临床治疗时除了应用抗生素、手术切开引流，还要注意控制血糖和积极的全身支持治疗，改善体质，促进痊愈。

关键词: 口腔颌面部, 间隙感染, 糖尿病, 老年, 治疗