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目的:研究伴发身体其他部位创伤的颌面伤患者综合救治中专科确定性手术时机和适应证。方法:回顾性统计4所大型综合医院口腔科病房近20年收治的4 869例口腔颌面部创伤患者的临床资料,分析伴发身体其他部位创伤状况和专科手术时机。结果:4 869例患者中,面骨骨折3 364例,软组织伤1 505例。伴发其他部位创伤1 524例(占31.3%),其中颅脑伤570例(37.4%),肢体伤545例(35.8%),胸部伤170例(11.2%),眼创伤151例(9.9%),脊柱伤54例(3.3%),腹部伤34例(2.2%)。74%的颅脑伴发伤患者伤后4周内、76.2%的眼伴发伤患者伤后7d内进行了面骨骨折手术治疗。而肢体、脊柱、胸腹部伴发伤患者,面骨骨折手术均有不同程度延误。结论:伴发多系统创伤的颌面伤患者的救治需要多学科间的合作,在患者呼吸系统、循环系统等全身状况稳定的情况下,大部分颌面多发伤患者可以同期或早期进行专科处理。
OBJECTIVE: To study the timing and indications of definite surgery in comprehensive treatment of maxillofacial injuries associated with trauma in other parts of the body. Methods: The clinical data of 4 869 patients with oral and maxillofacial trauma admitted in the dental department of four large general hospitals in recent 20 years were retrospectively analyzed. The traumatic status of other parts of the body and the timing of specialist surgery were analyzed. Results: Of the 4 869 patients, 3 364 had facial fractures and 1 505 had soft tissue injuries. There were 1 524 cases (31.3%) of other traumatic cases accompanied by 570 cases (37.4%) of traumatic brain injury, 545 cases (35.8%) of limb injuries, 170 cases (11.2%) of chest injuries and 151 cases (9.9% , 54 cases of spinal injury (3.3%) and 34 cases of abdominal injury (2.2%). 74% of craniocerebral injury patients within 4 weeks after injury, 76.2% of eyes with trauma patients within 7d after fracture surgery for facial fracture. The limbs, spine, chest and abdomen associated with traumatic patients, facial fracture surgery have varying degrees of delay. CONCLUSIONS: The management of maxillofacial trauma patients with multiple trauma requires multidisciplinary cooperation. When the general condition of the patient’s respiratory system, circulatory system and other conditions are stable, most patients with maxillofacial multiple traumatic injuries can undergo specialist treatment at the same or early stage .