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北京大学学报（医学版） ›› 2023, Vol. 55 ›› Issue (3): 543-547. doi: 10.19723/j.issn.1671-167X.2023.03.022

• 论著 • 上一篇    下一篇

口腔急诊颌面部感染患者临床分析

王哲1,孙伟1,杨雪1,宋颖2,姬爱平1,白洁1,*()   

  1. 1. 北京大学口腔医学院·口腔医院急诊科，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京 100081
    2. 北京大学口腔医学院·口腔医院医务处，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京 100081
  • 收稿日期:2021-10-09 出版日期:2023-06-18 发布日期:2023-06-12
  • 通讯作者: 白洁 E-mail:jiebai1999@163.com
  • 基金资助:
    北京大学口腔医院临床新技术新疗法项目(PKUSSNCT-18B06)

Clinical analysis of patients with oral and maxillofacial infections in oral emergency

Zhe WANG1,Wei SUN1,Xue YANG1,Ying SONG2,Ai-ping JI1,Jie BAI1,*()   

  1. 1. Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. Department of Medical Affairs, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2021-10-09 Online:2023-06-18 Published:2023-06-12
  • Contact: Jie BAI E-mail:jiebai1999@163.com
  • Supported by:
    the New Technology and New Therapy Project of Peking University School and Hospital of Stomatology(PKUSSNCT-18B06)

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摘要：

目的: 分析口腔急诊颌面部感染的病种构成、发病情况及临床特点，以指导口腔急诊颌面部感染的临床诊疗和预防。方法: 回顾性分析2017年1月至2019年12月期间就诊于北京大学口腔医院急诊科有完整电子病历信息的口腔颌面部感染患者，总结口腔急诊颌面部感染患者的疾病构成、性别、年龄分布、累及牙位等。结果: 共纳入口腔颌面部感染患者8 277例，其中男性患者4 378例(52.9%)，女性患者3 899例(47.1%)，男女比例1.12:1。口腔急诊科常见颌面部感染疾病依次有牙周脓肿(3 826例，46.2%)、牙槽脓肿(3 537例，42.7%)、间隙感染(740例，9.0%)、唾液腺炎症(108例，1.3%)、面部疖痈(56例，0.7%)、颌骨骨髓炎(10例，0.1%)。不同疾病好发性别不同：牙周脓肿、间隙感染、面部疖痈好发于男性患者，男女比例分别为1.24:1、1.26:1、2.50:1；牙槽脓肿、唾液腺炎症、面部疖痈发病性别差异不明显，男女比例为0.98:1、0.96:1、0.7:1。口腔颌面部感染高发年龄段为5~9岁、24~67岁。不同疾病好发年龄不同：牙槽脓肿发病高发年龄段为5~9岁、27~67岁；牙周脓肿高发年龄段为30~64岁；间隙感染高发年龄段为21~67岁；唾液腺炎症、面部疖痈、颌骨骨髓炎病例数较少，无明显高发年龄段。在所有口腔颌面部感染患者中，口腔脓肿患者共7 363例(牙周脓肿患者3 826例，牙槽脓肿患者3 537例)，占比88.9%，共累及7 999颗患牙，其中乳牙717颗，恒牙7 282颗。牙周脓肿通常发生于恒牙，其中以上下颌磨牙最易受累；牙槽脓肿在乳牙和恒牙中均有发生，好发于乳磨牙、上颌乳中切牙，以及上下颌第一恒磨牙。结论: 了解口腔急诊常见颌面部感染的发病情况，有利于临床疾病的诊断和正确处置，也有助于对不同年龄层和不同性别患者进行有针对性的宣教，预防疾病发生。

关键词: 口腔颌面部感染, 回顾性分析, 口腔急诊, 流行病学

Abstract:

Objective: To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency. Methods: A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted. General characteristics, such as disease composition, gender, age distribution and position of involved teeth were analyzed. Results: A total of 8 277 patients with oral and maxillofacial infections were finally collected, including 4 378 male patients (52.9%) and 3 899 female patients (47.1%), with gender ratio of 1.12:1. The common diseases were periodontal abscess (3 826 cases, 46.2%), alveolar abscess (3 537 cases, 42.7%), maxillofacial space infection (740 cases, 9.0%), sialadenitis (108 cases, 1.3%), furuncle & carbuncle (56 cases, 0.7%) and osteomyelitis (10 cases, 0.1%). Male patients were more easily affected by periodontal abscess, space infection and furuncle & carbuncle than female patients with the gender ratios 1.24:1, 1.26:1, 2.50:1 individually, while the incidence of alveolar abscess, sialadenitis, furuncle & carbuncle had no significant gender difference. Different diseases were prone to occur at different ages. The peak ages of alveolar abscess were 5-9 and 27-67 years, while the peak age of periodontal abscess was 30-64 years. Space infection tended to occur between 21-67 years. There were 7 363 patients with oral abscess (3 826 patients with periodontal abscess and 3 537 patients with alveolar abscess), accounting for 88.9% of all the patients with oral and maxillofacial infections, involving 7 999 teeth, including 717 deciduous teeth and 7 282 permanent teeth. Periodontal abscess usually occurred in permanent teeth, especially the molar teeth. Alveolar abscess may occur in both primary teeth and permanent teeth. In primary teeth, the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth. Conclusion: Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases, as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.

Key words: Oral and maxillofacial infections, Retrospective analysis, Oral emergency, Epidemiology

中图分类号: 

  • R782.3

表1

口腔颌面部感染性疾病的性别和年龄分布"

Diseases Total, n Gender Age/years
Male Female 0-10 >10-20 >20-30 >30-40 >40-50 >50-60 >60-70 >70-80 >80
Periodontal abscess 3 826 55.4 44.6 1.2 2.6 14.6 19.9 19.9 21.2 13.7 4.6 2.2
Alveolar abscess 3 537 49.5 50.5 18.9 3.7 12.4 13.1 12.6 16.0 12.4 7.2 3.7
Space infection 740 55.7 44.3 5.4 3.5 22.7 16.8 13.5 17.8 12.7 4.6 3.0
Sialadenitis 108 49.1 50.9 2.8 8.3 21.3 21.3 19.4 9.3 11.1 3.7 2.8
Furuncle & carbuncle 56 71.4 28.6 3.6 14.3 17.9 26.8 12.5 7.1 14.3 3.6 0.0
Osteomyelitis 10 40.0 60.0 0.0 0.0 10.0 0.0 10.0 30.0 10.0 20.0 20.0
Total 8 277 52.9 47.1 9.2 3.3 14.5 16.7 16.2 18.4 13.0 5.7 2.9

图1

各类感染性疾病的年龄分布"

图2

牙周脓肿好发牙位及数目"

图3

乳牙牙槽脓肿好发牙位及数目"

图4

恒牙牙槽脓肿好发牙位及数目"

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ISSN 1671-167X
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