本文關(guān)鍵詞：口腔頜面部狗咬傷患者一期縫合與延期縫合的療效比較　出處：《吉林大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2016年06期 　論文類型：期刊論文

  更多相關(guān)文章： 狗咬傷 一期縫合 延期縫合

【摘要】：目的:比較口腔頜面部狗咬傷患者行一期縫合與延期縫合治療的效果,探討一期縫合的可行性。方法:收集31例頜面部狗咬傷患者的臨床資料,按照縫合方式分為一期縫合組(20例)和延期縫合組(11例)。一期縫合組患者傷口周圍常規(guī)肥皂水沖洗,消毒皮膚,局部浸潤麻醉,徹底清創(chuàng),慶大霉素與甲硝唑交替沖洗,轉(zhuǎn)移皮瓣,縫合傷口,術(shù)后應(yīng)用抗生素并及時(shí)接種狂犬疫苗和破傷風(fēng)疫苗。延期縫合組患者傷口周圍常規(guī)肥皂水沖洗,消毒皮膚,局部浸潤麻醉,徹底清創(chuàng),慶大霉素與甲硝唑交替沖洗,無菌紗布覆蓋創(chuàng)面,定期更換敷料,傷口延期縫合,術(shù)后常規(guī)注射狂犬疫苗和破傷風(fēng)疫苗,全身應(yīng)用抗生素。比較2組患者傷口感染率和溫哥華瘢痕評(píng)定量表(VSS)評(píng)分。結(jié)果:一期縫合組20例患者中,有2例(10.00%)出現(xiàn)不同程度的傷口感染,無全身性感染出現(xiàn),均未發(fā)生狂犬病及破傷風(fēng);延期縫合組11例患者中,有2例(9.09%)出現(xiàn)不同程度的傷口感染,無全身性感染出現(xiàn),均未發(fā)生狂犬病及破傷風(fēng)。2組患者傷口感染率比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。一期縫合組患者VSS評(píng)分(Z=257)高于延期縫合組(Z=239),組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:一期縫合患者傷口感染率與延期縫合相近,但一期縫合的傷口比延期縫合更美觀,適用于口腔頜面部狗咬傷患者。
[Abstract]:Objective: To compare the effect of one-stage suture and delayed suture for patients with oral and maxillofacial bites, and to explore the feasibility of primary suture. Methods: the clinical data of 31 cases of maxillofacial dog bites were collected and divided into one stage suture group (20 cases) and delayed suture group (11 cases) according to the suture method. Patients in the primary suture group were washed with conventional soap solution, sterilized skin, local infiltration anesthesia, thorough debridement, gentamicin and metronidazole alternately rinsed, transferred skin flap, suture wounds, postoperative antibiotics were applied, and rabies vaccine and tetanus vaccine were vaccinated in time. Delayed suture group were wound around the regular soap and water, skin disinfection, local anesthesia, debridement, gentamicin and metronidazole douche, sterile gauze to cover the wound and change dressing regularly, delayed suture of wound, postoperative routine injection of rabies vaccine and tetanus vaccine wind, systemic antibiotics. The rate of wound infection and the scale of Vancouver scar assessment scale (VSS) were compared between the 2 groups. Results: a suture group of 20 patients, 2 cases (10%) with varying degrees of wound infection, no systemic infection occurred, rabies and tetanus; delayed suture group of 11 patients, 2 cases (9.09%) with varying degrees of wound infection, no systemic infection occurred. There was no rabies and tetanus. There was no significant difference in the rate of wound infection between the 2 groups (P0.05). The VSS score (Z=257) in the primary suture group (Z=239) was higher than that in the delayed suture group (Z=239), and there was a significant difference between the groups (P0.05). Conclusion: the rate of wound infection is similar to that of delayed suture, but the primary wound is more beautiful than the delayed suture. It is suitable for patients with oral and maxillofacial dog bite.
【作者單位】： 吉林大學(xué)口腔醫(yī)院牙體牙髓病科;長春醫(yī)學(xué)高等�？茖W(xué)�？谇唤萄惺�;吉林大學(xué)口腔醫(yī)院牙周病科;吉林大學(xué)口腔醫(yī)院口腔頜面外科;
【基金】：吉林省衛(wèi)計(jì)委青年科研項(xiàng)目資助課題(3D514CP23431) 吉林省科技廳自然科學(xué)基金資助課題(3D515V663431)
【分類號(hào)】：R782.4
【正文快照】： 狗咬傷是口腔頜面部最常見的疾病之一。在與動(dòng)物有關(guān)的傷害中,狗咬傷占60%~80%[1]。城市里狗咬傷的發(fā)生率高于農(nóng)村[2],頜面部狗咬傷通常與整形外科有關(guān)[3]。狗咬傷患者在急診中占1%,但至今對(duì)狗咬傷抗菌治療仍缺少嚴(yán)格的標(biāo)準(zhǔn),絕大多數(shù)情況下是憑借經(jīng)驗(yàn)治療,研究[1]顯示近20%狗，

本文編號(hào)：1339789