Email Alert | RSS

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)

RICH HTML

   

PDF (PC)

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"

1 郭传瑸, 张益. 口腔颌面外科学[M]. 3版 北京: 北京大学医学出版社, 2021: 132.
2 Gonçalves L , Lauriti L , Yamamoto MK , et al. Characteristics and management of patients requiring hospitalization for treatment of odontogenic infections[J]. J Craniofac Surg, 2013, 24 (5): 458- 462.
doi: 10.1097/SCS.0b013e3182902e95
3 Zhang Q , Kreulen CM , Witter DJ , et al. Oral health status and prosthodontic conditions of Chinese adults: A systematic review[J]. Int J Prosthodont, 2007, 20 (6): 567- 572.
4 Ibiyemi ST , Okoje-Adesomoju VN , Dada-Adegbola HO , et al. Pattern of orofacial bacterial infections in a tertiary hospital in Southwest, Nigeria[J]. J West Afr Coll Surg, 2014, 4 (4): 112- 141.
5 Storoe W , Haug RH , Lillich TT . The changing face of odontoge-nic infections[J]. J Oral Maxillofac Surg, 2001, 59 (7): 739- 748.
doi: 10.1053/joms.2001.24285
6 Sakaguchi M , Sato S , Ishiyama T , et al. Characterization and management of deep neck infections[J]. Int J Oral Maxillofac Surg, 1997, 26 (2): 131- 134.
doi: 10.1016/S0901-5027(05)80835-5
7 Zhang CX , Tang YL , Zheng M , et al. Maxillofacial space infection experience in West China: A retrospective study of 212 cases[J]. Int J Infect Dis, 2010, 14 (5): 414- 417.
doi: 10.1016/j.ijid.2009.08.002
8 Han X , An J , Zhang Y , et al. Risk factors for life-threatening complications of maxillofacial space infection[J]. J Craniofac Surg, 2016, 27 (2): 385- 390.
doi: 10.1097/SCS.0000000000002416
9 Ladrillo TE , Hobdell MH , Caviness AC . Increasing prevalence of emergency department visits for pediatric dental care, 1997—2001[J]. J Am Dent Assoc, 2006, 137 (3): 379- 385.
doi: 10.14219/jada.archive.2006.0188
10 Qian Y , Ge Q , Zuo W , et al. Maxillofacial space infection experience and risk factors: A retrospective study of 222 cases[J]. Ir J Med Sci, 2021, 190 (3): 1045- 1053.
doi: 10.1007/s11845-020-02431-z
11 Farmakis ET , Palamidakis FD , Skondra FG , et al. Emergency care provided in a Greek dental school and analysis of the patients' demographic characteristics: A prospective study[J]. Int Dent J, 2016, 66 (5): 280- 286.
doi: 10.1111/idj.12245
12 Cheng Y , Cheung GS , Bian Z , et al. Incidence and factors associated with endodontic inter-appointment emergency in a dental teaching hospital in China[J]. J Dent, 2006, 34 (7): 516- 521.
doi: 10.1016/j.jdent.2005.12.003
13 Akinbami BO , Akadiri O , Gbujie DC . Spread of odontogenic infections in Port Harcourt, Nigeria[J]. J Oral Maxillofac Surg, 2010, 68 (10): 2472- 2477.
doi: 10.1016/j.joms.2010.01.019
14 Kudiyirickal MG , Hollinshead F . Clinical profile of orofacial infections: An experience from two primary care dental practices[J]. Med Oral Patol Oral Cir Bucal, 2012, 17 (4): 533- 537.
15 Osunde OD , Akhiwu BI , Efunkoya AA , et al. Management of fascial space infections in a Nigerian teaching hospital: A 4-year review[J]. Niger Med J, 2012, 53 (1): 12- 15.
doi: 10.4103/0300-1652.99823
16 Giunta-Crescente C , de Facchin M , Acevedo-Rodríguez AM . Medical-dental considerations in the care of children with facial cellulitis of odontogenic origin. A disease of interest for pediatricians and pediatric dentists[J]. Arch Argent Pediatr, 2018, 116 (4): 548- 553.
17 Ugboko VI , Owotade FJ , Ajike SO , et al. A study of orofacial bacterial infections in elderly Nigerians[J]. SADJ, 2002, 57 (10): 391- 394.
18 黄芳芳, 田玲, 韦倩, 等. 第三磨牙来源的口腔颌面部间隙感染危险因素分析[J]. 口腔颌面外科杂志, 2020, 30 (4): 234- 238.
doi: 10.3969/j.issn.1005-4979.2020.04.008
[1] 徐训敏,邵校,姬爱平. 口腔急诊科死亡病例分析[J]. 北京大学学报（医学版）, 2024, 56(1): 185-189.
[2] 王子恺,莫佳丽,张蒙,廖纪萍. 2013—2020年北京市慢性阻塞性肺疾病急性加重女性住院患者的流行病学和住院费用分析[J]. 北京大学学报（医学版）, 2023, 55(6): 1074-1081.
[3] 姚晓莹,刘志科,李宁,马瑞,赵薛飞,张良,许国章,詹思延,方挺. 2015—2019年宁波市0~36月龄婴幼儿癫痫发病的流行病学研究[J]. 北京大学学报（医学版）, 2021, 53(3): 485-490.
[4] 董彦会,陈曼曼,王丽萍,星一,宋逸,邹志勇,董彬,李中杰,马军. 中国6~22岁学生群体甲乙丙类传染病流行趋势[J]. 北京大学学报（医学版）, 2021, 53(3): 498-505.
[5] 邓思危,陈则亦,刘志科,王健,卓琳,高双庆,余家阔,詹思延. 基于城镇医保数据库骨关节伤病的流行病学研究[J]. 北京大学学报（医学版）, 2020, 52(3): 527-534.
[6] 赵丽君,李宏田,张亚黎,周玉博,刘建蒙. 基于移动终端开展中国新生儿出生特征研究[J]. 北京大学学报（医学版）, 2019, 51(5): 813-818.
[7] 刘园，栾庆先. 北京石景山社区中老年人群慢性牙周炎和颈动脉内膜中层厚度的相关性[J]. 北京大学学报(医学版), 2018, 50(2): 264-270.
[8] 李宁，刘昊楠，龚晓峰，朱仕文，吴新宝，贺良. 北京某三甲医院股骨颈骨折住院患者现状的流行病学分析[J]. 北京大学学报(医学版), 2016, 48(2): 292-296.
[9] 周玉博, 罗树生, 李宏田, 高燕秋, 刘建蒙. 1996年至2013年中国婚前医学检查率变化情况[J]. 北京大学学报（医学版）, 2015, 47(3): 437-442.
[10] 孙丽娜, 陈亚红, 沈宁, 路明, 姚婉贞. 慢性阻塞性肺疾病新病情评估方法的分布及意义[J]. 北京大学学报（医学版）, 2014, 46(4): 662-667.
[11] 李恒, 黄悦勤, 马亚婷, 刘肇瑞. 中国归因于非痴呆器质性精神障碍残疾的描述性流行病学研究[J]. 北京大学学报（医学版）, 2014, 46(2): 247-253.
[12] 邓秋菊，潘雅琪，王朝义，李凤垒，吕绍江，胡绍用，宁涛，郭传海，何忠虎，柯杨. 河南滑县农村地区成人乙型肝炎表面抗原检出率及相关因素分析[J]. 北京大学学报（医学版）, 2013, 45(6): 965-970.
[13] 周文娟, 梁爱民, 王凤芝, 崔文红, 王秀云, 刘秋明, 游红, 贺春燕, 彭金荣, 张迎武, . 北京市四区/县18月龄儿童发育迟缓的流行病学研究[J]. 北京大学学报（医学版）, 2013, 45(2): 211-.
[14] 詹思延. 药物流行病学理论和方法的发展[J]. 北京大学学报（医学版）, 2013, 45(03): 343-346.
[15] 刘括, 王晋伟, 余治平, 秦雪英, 武轶群, 李娜, 隗瑛琦, 方凯, 王雪茵, 吴涛, . PDE4D基因多态性与缺血性卒中的关联性研究[J]. 北京大学学报（医学版）, 2013, 45(03): 359-363.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 杨天智, 陈大兵, 张强. 不同吸收促进剂及酶抑制剂对胰岛素体内及体外口腔黏膜渗透性的影响[J]. 北京大学学报（医学版）, 2001, 33(3): 238 -242 .
[2] 柳晓辉, 那加, 刘玲玲, 罗斌. 头颈部血管肉瘤3例[J]. 北京大学学报（医学版）, 2001, 33(3): 288 -289 .
[3] 梁成, 王兴, 伊彪, 李自力, 王晓霞. 骨性颞下颌关节强直伴小颌畸形及阻塞性睡眠呼吸暂停综合征的牵引成骨治疗[J]. 北京大学学报（医学版）, 2002, 34(2): 112 -116 .
[4] 郭应禄, 张凯. 临床研究所要创高水平医疗[J]. 北京大学学报（医学版）, 2002, 34(5): 431 -433 .
[5] 方鹏骞, 徐娟, 张佳慧, 李翠, 杨芳, 孔鹏, 孙杨. 艾滋病高危人群规模间接估计方法的应用及其结果的外推研究[J]. 北京大学学报（医学版）, 2008, 40(2): 214 -218 .
[6] 胡维亨, 任军. 人乙型肝炎病毒DNA阳性血清对人骨髓间充质干细胞向肝细胞分化的影响[J]. 北京大学学报（医学版）, 2008, 40(5): 459 -464 .
[7] 龚继芳, 袁艳华, 宋国红, 余靖, 贾军, 任军. CD44+/CD24-/low/ABCG2-乳腺癌干细胞比例增高与临床治疗相关的探索性研究[J]. 北京大学学报（医学版）, 2008, 40(5): 465 -470 .
[8] 邸立军, 任军, 宋国红, 余靖, 方健, 车利, 祝毓琳. 自体外周血CD34+干细胞来源树突状细胞体外扩增治疗恶性体腔积液[J]. 北京大学学报（医学版）, 2008, 40(5): 486 -488 .
[9] 张勇, 栾庆先. 牙周维护治疗在保持牙周长期疗效中的作用[J]. 北京大学学报（医学版）, 2011, 43(1): 29 -33 .
[10] 曾百进, 余日月, 周永胜, 徐军, 倪永伟, 刘云松, 许永伟. rhTNF-α对成骨向分化前后的人脂肪基质细胞分泌血管生成相关生长因子的影响[J]. 北京大学学报（医学版）, 2009, 41(5): 565 -570 .
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部