本文選題：口腔頜面部間隙感染 + 病原菌　； 參考：《中華醫(yī)院感染學(xué)雜志》2017年04期

【摘要】：目的探討患者口腔頜面部間隙感染(MSI)的感染來源、并發(fā)癥發(fā)生及危險因素,為臨床MSI感染的診治提供依據(jù)。方法選擇2014年1月-2015年12月醫(yī)院口腔科MSI患者120例為研究對象,收集患者的臨床資料。結(jié)果 120例患者MSI的感染來源包括牙源性感染67例(55.8%)和非牙源性感染53例(44.2%),其中牙源性感染包括根尖周炎27例(22.5%),智牙冠周炎23例(19.2%),牙周病16例(13.3%),其他1例(0.8%);非牙源性感染包括腺源性感染16例(13.3%),非特異性淋巴結(jié)炎14例(11.7%),皮膚感染13例(10.8%),骨髓炎6例(5.0%),其他4例(3.3%);65例病原菌培養(yǎng)結(jié)果陽性,45例培養(yǎng)結(jié)果為單一致病菌,20例培養(yǎng)結(jié)果為混合感染,共培養(yǎng)菌株85株,主要病原菌為肺炎克雷伯菌24株占28.2%、釀膿鏈球菌19株占22.4%、金黃色葡萄球菌19株占22.4%和厭氧菌18株占21.2%;120例患者中18例患者出現(xiàn)并發(fā)癥,其中12例出現(xiàn)呼吸困難,3例出現(xiàn)肺炎,2例出現(xiàn)胸腔積液,1例出現(xiàn)呼吸衰竭;單因素分析結(jié)果發(fā)現(xiàn),糖尿病、白細胞計數(shù)≥15×109/L、多間隙感染者并發(fā)癥的發(fā)生率(24.4%、26.3%、39.1%)高于無糖尿病、白細胞計數(shù)15×109/L、單間隙感染者(10.1%、9.8%、9.3%),差異有統(tǒng)計學(xué)意義(P0.05);多因素分析結(jié)果發(fā)現(xiàn),白細胞計數(shù)≥15×109/L和多間隙感染是發(fā)生并發(fā)癥的獨立危險因素,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論 MSI主要來源于牙源性感染,主要病原菌為釀膿鏈球菌和肺炎克雷伯菌,白細胞計數(shù)≥15×109/L和多間隙感染是發(fā)生MSI并發(fā)癥的獨立危險因素。
[Abstract]:Objective to investigate the origin, complications and risk factors of oral and maxillofacial space infection (MSI) in order to provide evidence for the diagnosis and treatment of MSI infection. Methods 120 MSI patients from January 2014 to December 2015 were selected and their clinical data were collected. Results the sources of MSI infection in 120 patients included odontogenic infection in 67 cases (55.8%) and non-odontogenic infection in 53 cases (44.2%), including periodontitis in 27 cases (22.5%), pericoronitis in 23 cases (19.2%), periodontal disease in 16 cases (13.3%), non-dental infection in 1 case (0.8%), odontogenic infection in 27 cases (22.5%), periodontal periodontitis in 23 cases (19.2%), periodontal disease in 16 cases (13.3%), and other cases in 0.8%. There were 16 cases of adenogenic infection (13.3%), 14 cases of nonspecific lymphadenitis (11.7%), 13 cases of skin infection (10.8%), 6 cases of osteomyelitis (5.0%), and 4 cases (3.3%) of the other 65 cases (3.3%). The main pathogens were Klebsiella pneumoniae (24 strains), Streptococcus pyogenes (19 strains), Staphylococcus aureus (22.4%) and anaerobic bacteria (18 strains). Among them, 12 cases had dyspnea, 3 cases had pneumonia and 2 cases had pleural effusion and 1 case had respiratory failure. Univariate analysis showed that the incidence of complications in diabetes mellitus, leukocyte count 鈮，

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