新型冠状病毒肺炎疫情下25例口腔颌面外科急诊患者临床分析

doi:10.19438/j.cjoms.2020.02.003

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (2): 105-110.doi: 10.19438/j.cjoms.2020.02.003

新型冠状病毒肺炎疫情下25例口腔颌面外科急诊患者临床分析

郭宇轩^1,*, 丛丙峰^2,*, 陆金标¹, 杨勇¹, 刘义闻¹, 丁明超¹, 马婕¹, 陈媛丽¹, 栗茜³, 刘彦普¹, 田磊¹

1.第四军医大学口腔医院颌面创伤与正颌外科,军事口腔医学国家重点实验室, 口腔疾病国家临床医学研究中心,陕西省口腔疾病国际联合研究中心, 第四军医大学口腔医学院,陕西西安 710032;
2.第四军医大学口腔医院颌面整形美容外科;
3.手术室,陕西西安 710032

收稿日期:2020-02-26 修回日期:2020-02-27 出版日期:2020-03-20 发布日期:2020-04-30
通讯作者: 田磊,E-mail：tianleison@163.com
作者简介:郭宇轩（1990-）,女,硕士,E-mail：yu.xuan1221@163.com;丛丙峰（1989-）,男,硕士,E-mail：congbingfeng999@163.com。^*并列第一作者

Clinical analysis of 25 oral and maxillofacial emergency patients during the period of COVID-19 epidemic

GUO Yu-xuan¹, CONG Bing-feng², LU Jin-biao¹, YANG Yong¹, LIU Yi-wen¹, DING Ming-chao¹, MA Jie¹, CHEN Yuan-li¹, LI Qian³, LIU Yan-pu¹, TIAN Lei¹

1.Department of Maxillofacial Trauma and Orthognathic Surgery,State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University. Xi'an 710032;
2.Department of Maxillofacial Plastic and Cosmetic Surgery;
3.Operation Room of School of Stomatology, The Fourth Military Medical University. Xi'an 710032, Shaanxi Province, China

Received:2020-02-26 Revised:2020-02-27 Online:2020-03-20 Published:2020-04-30

摘要/Abstract

摘要： 目的:总结分析在新型冠状病毒肺炎（COVID-19）流行期间,第四军医大学口腔医院口腔颌面外科收治的急诊患者情况、收治流程、手术方法与感染防控措施,为制订COVID-19流行期间的口腔颌面外科急诊治疗规范提供参考。方法:收集2020年1月23日—2月20日第四军医大学口腔医院口腔颌面外科收治的所有急诊病例,对患者情况进行统计分析,包括患者性别与年龄、疾病种类、致病原因、手术时间等,并探讨流行病学特点和意义,疫情期间口腔颌面外科急诊处置流程与手术要点。结果:疫情期间,口腔颌面外科共收治25例急诊患者,其中男10例,女15例;≥18岁13例,<18岁12例;颌面部挫裂伤11例,下颌骨骨折10例,间隙感染4例。24例患者行手术治疗,5例在病房治疗室局麻下行清创缝合术,医护人员按二级防护级别操作;其余19例均在负压手术室内完成手术,医护人员按三级防护操作。所有患者均成功治疗,诊疗期间未发生COVID-19感染。结论:COVID-19疫情期间,口腔颌面外科急诊以外伤为主,意外摔伤是主要致伤因素,儿童和女性急诊患者比例较大;交通事故是造成颌骨骨折的主要原因。收治口腔颌面急诊患者时,应注重采取防护措施。在仔细评估伤情、遵守治疗原则的基础上,可简化手术操作,缩短手术时间。口腔颌面外科医师应与感控专家和医院管理层建立顺畅的联系,尽可能降低COVID-19感染风险。

关键词: 新型冠状病毒, 口腔颌面外科, 急诊, 颌骨骨折, 颌面部间隙感染

Abstract: PURPOSE：The purpose of this study was to analyze the features and treatment protocols of emergency cases treated in the Department of Oral and Maxillofacial Surgery, The Fourth Military Medical University during the period of COVID-19 epidemic, summarize the prevention and control measures, and provide reference for establishing oral and maxillofacial emergency treatment standard during the epidemic period. METHODS: The information of 25 emergency patients who were treated from 23 January 2020 to 20 February 2020 was collected. Then patients' data were analyzed according to the age, gender, disease and pathogeny. The therapeutic protocol for oral and maxillofacial emergency cases during the period of COVID-19 epidemic and the details of operation were investigated and discussed. RESULTS: During the epidemic period, 25 emergency patients were successfully treated. Among them, there were 10 males and 15 females, twelve patients were younger than 18 years old. Eleven patients were diagnosed as oral and facial laceration, while 10 patients were diagnosed as mandibular fractures. Five patients were given minor debridement in clinical room under local anesthesia with second-degree protection of the medical staff. Nineteen patients underwent surgery in negative pressure with the third-degree protection equipment. All patients were discharged in 3 weeks and infection of COVID-19 was not found in the whole therapeutic process. CONCLUSIONS: Facial injury is the leading cause of maxillofacial emergency during the period of COVID-19 epidemic. Children and woman are prone to facial trauma than adult man. Fall down is the main injury cause rather than traffic accident, while traffic accident is prone to lead mandibular fractures. The utmost point of treating oral and maxillofacial emergency patients in this special time is adopting strict prevention and protection measures during the whole therapeutic process. Oral and maxillofacial surgeons should give patients a simple, effective and definite approach to reduce the duration of operation, they must have good communication with infection control professionals and the hospital administrations.

Key words: COVID-19, Oral and maxillofacial surgery, Emergency, Mandibular Fracture, Maxillofacial space infection

中图分类号:

R782.4

郭宇轩, 丛丙峰, 陆金标, 杨勇, 刘义闻, 丁明超, 马婕, 陈媛丽, 栗茜, 刘彦普, 田磊. 新型冠状病毒肺炎疫情下25例口腔颌面外科急诊患者临床分析[J]. 中国口腔颌面外科杂志, 2020, 18(2): 105-110.

GUO Yu-xuan, CONG Bing-feng, LU Jin-biao, YANG Yong, LIU Yi-wen, DING Ming-chao, MA Jie, CHEN Yuan-li, LI Qian, LIU Yan-pu, TIAN Lei. Clinical analysis of 25 oral and maxillofacial emergency patients during the period of COVID-19 epidemic[J]. China J Oral Maxillofac Surg, 2020, 18(2): 105-110.

参考文献

[1] Wang F S, Zhang C.What to do next to control the 2019-nCoV epidemic?[J] Lancet, 2020, 395(10222):391-393.
[2] 国家卫生健康委办公厅关于印发新型冠状病毒感染的肺炎防控方案(第4版)的通知[EB/OL].[2020-02-07 ]. http://www.gov.cn/zhengce/zhengceku/2020-02/07/content_5475813.htm.
[3] Chen H, Guo J, Wang C, et al.Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records[J] Lancet, 2020. DOI:https://doi.org/10.1016/S0140-6736(20)30360-3.
[4] 国家卫生健康委办公厅. 国家卫生健康委办公厅关于加强重点地区重点医院发热门诊管理及医疗机构内感染防控工作的通知[EB/OL]. http://wsjkw.hebei.gov.cn/index.do?templet=content &id=396790&cid=43
[5] 卢阳,卢晓峰,范先群. 621例颅颌面骨折临床分析[J].上海口腔医学,2017,26(1):106-110.
[6] 丁磊,曹俊,鲁勇,等. 311例口腔颌面部间隙感染患者的回顾性分析[J].口腔医学,2019,39(02):121-125.
[7] 王涛,李建虎,许志鹏, 等.口腔颌面部间隙感染患者的临床特点及病原菌分析[J].实用口腔医学杂志,2018,34(06):809-812.
[8] Chuang KT, Hsieh F, Liao HT.The correlation of age and patterns of maxillofacial bone fractures and severity of associated injuries caused by motorcycle accidents[J]. Ann Plast Surg,2019,83(6): e28-e34.
[9] 陈辉,刘彦普,刘斌.1001例口腔颌面部创伤患者临床分析[J].中国口腔颌面外科杂志,2012,10(2):129-133.
[10] 中华口腔医学会口腔颌面外科专业委员会. 口腔颌面外科手术在新型冠状病毒感染流行期管理的专家意见[J]. 中国口腔颌面外科杂志2020,18(2):97-99.
[11] 张天嘉,刘婷,罗淞元,等. 新型冠状病毒防控阶段口腔颌面创伤管理策略[J]. 中国口腔颌面外科杂志, 2020, 18(2): 100-104.
[12] 张艳霞,刘雯,孔亮,等. 新型冠状病毒感染疫情期口腔医院工作人员的防护标准[J].实用口腔医学杂志,2020.03,36(2).DOI:10.3969/j.issn.1001~3733.2020.01.0.
[13] 李承浩,石冰.口腔颌面外科手术合并新型冠状病毒感染的管理策略[J].口腔颌面外科杂志,2020, 30(1): 5-8.

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新型冠状病毒肺炎疫情下25例口腔颌面外科急诊患者临床分析

Clinical analysis of 25 oral and maxillofacial emergency patients during the period of COVID-19 epidemic

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