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我院于1984年8月收治因拔牙后出现严重并发症而致死亡1例,现报告如下。李××,女,25岁,某部战士。1984年8月6日因左下智齿急性冠周炎在某单位拔除患牙后左颌下出现渐进性肿痛,术后第3天体温39℃。当日行左颌下脓肿切开排脓引流。静脉滴注红霉素、肌注青霉素、链霉素等治疗不见好转。有进食呛咳,呼吸困难。8月4日术后第8天上午急诊收入我院口腔科。过去史个人史、家族史无特殊。入院后体温38.3℃,脉搏120次,呼吸18次,血压13.3/6.7kpa。白细胞计数1.2×10~9/L,中性0.85,淋巴0.15。其余正常。治疗经过及病情变化:入院后按颌下间隙感染应用多种抗菌素治疗。因右侧胸痛呼吸困难、不能平卧并有持续高热,于17日第2次摄胸片示:“右胸腔大量积液”,穿刺抽出脓液900ml,当日行右侧胸腔闭式引流,术后12小时引流出脓性液1800ml,培养为多形模仿杆菌,氨苄青霉素(++),羧苄青霉素(+)。血培养(-)。加强抗感染及支持治疗。氨苄青霉素2 g每日
In our hospital in August 1984 admitted to a serious complication due to tooth extraction and death in 1 case, are as follows. Lee × ×, female, 25 years old, a soldier. August 6, 1984 due to acute left lower left wisdom teeth pericoronitis in a unit removal of the teeth after the left mandibular progressive swelling and pain, body temperature 39 ℃ after 3 days. On the day line of left submandibular abscess incision drainage drainage. Intravenous infusion of erythromycin, intramuscular penicillin, streptomycin and other treatment did not improve. Choking cough, difficulty breathing. August 4 postoperative 8th morning emergency income in our hospital Department of Stomatology. Past history Personal history, family history no special. After admission, body temperature 38.3 ℃, pulse 120 times, breathing 18 times, blood pressure 13.3 / 6.7kpa. White blood cell count 1.2 × 10 ~ 9 / L, neutral 0.85, lymph 0.15. The rest normal. After treatment and changes in the condition: After admission by submandibular space infection with a variety of antibiotic treatment. Due to the right chest pain, difficulty breathing, can not supine and sustained high fever, on the 2nd of the 17th chest radiograph showed: “right pleural effusion” puncture pus out of 900ml, the right line of the thoracic drainage line the day After 12 hours of drainage of purulent fluid 1800ml, cultured for polymorphism mimic bacilli, ampicillin (+ +), carbenicillin (+). Blood culture (-). Strengthen anti-infection and supportive treatment. Ampicillin 2 g daily