本文選題：口腔頜面部 + 面神經(jīng)損傷��； 參考：《鄭州大學(xué)》2014年碩士論文

【摘要】：背景和目的 創(chuàng)傷是指機(jī)械力能量傳給人體后所造成機(jī)體結(jié)構(gòu)完整性破壞的損傷，它伴隨著人類的誕生、勞動(dòng)、和一切社會活動(dòng)，縱觀古今中外，，人們對創(chuàng)傷的認(rèn)知與處理水平是一個(gè)不斷提升的過程。隨著社會經(jīng)濟(jì)的發(fā)展和人們生活模式的改變，和平年代創(chuàng)傷又有了全新的定義，創(chuàng)傷作為“發(fā)達(dá)社會疾病”不僅威脅著人類的身體健康更重要的是對患者心理造成很大的影響，對人們的生存質(zhì)量及人口素質(zhì)都有很嚴(yán)重的影響。河南地處中國中東部交通發(fā)達(dá)，是我國的人口大省，截止2013年末全省總?cè)丝谶_(dá)到9417萬。近年來我省經(jīng)濟(jì)的高速發(fā)展，隨著高速交通工具的普及以及道路基礎(chǔ)建設(shè)的改善，因交通事故導(dǎo)致創(chuàng)傷的患者數(shù)量與日俱增。但截至目前，河南地區(qū)頜面部創(chuàng)傷的流行病學(xué)特點(diǎn)分析的報(bào)道卻極為少見。本次研究通過對鄭州大學(xué)第一附屬醫(yī)院口腔醫(yī)學(xué)中心頜面外科收治的頜面部創(chuàng)傷住院患者進(jìn)行回顧性分析，主要通過數(shù)據(jù)庫對口腔頜面部創(chuàng)傷的致傷原因、合并傷及治療方法等相關(guān)數(shù)據(jù)進(jìn)行分析，得出口腔頜面部創(chuàng)傷的流行病學(xué)資料，為減少和預(yù)防頜面部創(chuàng)傷引起的頜面部骨折提供數(shù)據(jù)參考。同時(shí)通過對相關(guān)神經(jīng)損傷患者的病歷資料的分析，探討頜面神經(jīng)損傷后功能恢復(fù)規(guī)律及相關(guān)影響因素。 材料與方法 總結(jié)分析鄭州大學(xué)第一附屬醫(yī)院口腔醫(yī)學(xué)中心頜面外科病房2011.7～2014.1期間收治的頜面部創(chuàng)傷住院患者，共搜集到病歷資料完整的頜面部損傷患者住院病歷479例。用條圖、線圖和圓圖等直觀圖表以及具體數(shù)據(jù)來說明統(tǒng)計(jì)結(jié)果�；仡櫺苑治鲱M面創(chuàng)傷致頜面神經(jīng)損傷患者的病歷資料，包括損傷部位、損傷方式對頜面部神經(jīng)功能恢復(fù)結(jié)果的影響，結(jié)果以統(tǒng)計(jì)圖表的形式進(jìn)行描述性分析。其中面神經(jīng)損傷前后功能評定，采用目前國際通用的HB評價(jià)(House—Brackmann facial nerve grading)。 結(jié)果 479例頜面創(chuàng)傷患者，男女比例3.17：1；交通事故在致傷原因中占據(jù)首位（60.33%）；在頜面諸骨中下頜骨是骨折的好發(fā)部位（43.62%）；四肢及顱腦（42.08%，30.60%）損傷是頜面部骨折常見合并傷；術(shù)中出現(xiàn)神經(jīng)損傷患者41例，占全部手術(shù)患者的10.49%。面神經(jīng)及頦神經(jīng)損傷比率最高，各占37.20%；眶下神經(jīng)損傷患者中10例（38.46%）于術(shù)后1周開始恢復(fù)。面神經(jīng)分支損傷患者中12例（57.14%），在術(shù)后2周左右恢復(fù)正常。頦神經(jīng)損傷患者中8例（47.06%)。而面神經(jīng)主干損傷患者1例（33.33%），在術(shù)后半年開始恢復(fù)。目前手術(shù)切開復(fù)位堅(jiān)強(qiáng)內(nèi)固定術(shù)已成為治療頜面部骨折的首選治療方式； 結(jié)論 頜面部創(chuàng)傷的首要原因?yàn)榻煌ㄊ鹿�，頜面骨折以下頜骨最為多見。感覺神經(jīng)術(shù)后恢復(fù)較快，運(yùn)動(dòng)神經(jīng)恢復(fù)則相對較慢。面神經(jīng)HB功能Ⅲ級以內(nèi)的損傷患者預(yù)后較好。HB功能≥IV級的患者，預(yù)后則較差。
[Abstract]:Background and objective Trauma refers to the damage to the structural integrity of the body caused by the transmission of mechanical force and energy to the human body. It is accompanied by the birth of human beings, labor, and all social activities, throughout history and all over the world. The level of cognition and treatment of trauma is an increasing process. With the development of society and economy and the change of people's life mode, trauma in peacetime has been defined completely. Trauma, as a "disease of developed society", not only threatens the health of human beings, but also has a great influence on patients' psychology. People's quality of life and the quality of the population have a very serious impact. Henan, located in the middle and eastern part of China, is a populous province with a total population of 94.17 million by the end of 2013. In recent years, with the rapid development of economy in our province, with the popularization of high-speed transportation and the improvement of road infrastructure, the number of patients with trauma caused by traffic accidents is increasing day by day. But so far, the epidemiological analysis of maxillofacial trauma in Henan is rare. In this study, we retrospectively analyzed the causes of maxillofacial trauma caused by oral and maxillofacial trauma in the oral and maxillofacial trauma patients in the stomatology Center of the first affiliated Hospital of Zhengzhou University. The epidemiological data of oral and maxillofacial trauma were obtained by analyzing the related data such as combined injury and treatment methods, which provided a data reference for reducing and preventing maxillofacial fracture caused by maxillofacial trauma. At the same time, through the analysis of the medical records of patients with related nerve injuries, To investigate the regularity of functional recovery after maxillofacial nerve injury and the related influencing factors. Materials and methods the patients with maxillofacial trauma admitted from the maxillofacial surgery ward of the Stomatology Center of the first affiliated Hospital of Zhengzhou University were analyzed. A total of 479 inpatients with maxillofacial injuries were collected. Use bar diagram, diagram and circle chart and other visual charts and specific data to explain the results. The medical records of patients with maxillofacial nerve injury caused by maxillofacial trauma were analyzed retrospectively, including the location of injury and the effect of injury mode on the recovery of maxillofacial nerve function. The results were analyzed in the form of statistical chart. The function of facial nerve was evaluated before and after injury, and House-Brackmann facial nerve evaluation was used to evaluate House-Brackmann facial nerve grading.Results there were 479 patients with maxillofacial trauma. The ratio of male to female is 3.17: 1; traffic accident occupies the first place among the causes of injury: 60.33; the mandible is the most common site of fracture in maxillofacial bones; the mandible is the most common site for fracture; and the limbs and brain are 42.08 and 30.60.) injuries are common and complicated injuries in maxillofacial fractures. It accounted for 10.49% of all patients undergoing operation. The ratio of facial nerve injury and mental nerve injury was the highest (37.20%, respectively), and 10 cases of suborbital nerve injury (38.46%) began to recover 1 week after operation. Twelve patients with facial nerve branch injury recovered to normal 2 weeks after operation. Of the 8 patients with mental nerve injury, 47.06 were involved. One patient with facial nerve trunk injury began to recover half a year after operation. At present, open reduction and rigid internal fixation has become the first choice for the treatment of maxillofacial fractures. Conclusion the primary cause of maxillofacial injuries is traffic accidents, and mandibular fractures are the most common. The recovery of sensory nerve was faster than that of motor nerve. The prognosis of the patients with HB grade 鈪

本文編號：2000257