重症口腔疾病患者的选择性气管切开术评分系统。
Elective tracheostomy scoring system for severe oral disease patients.
作者信息
Kim Yong-Hwan, Kim Moon-Young, Kim Chul-Hwan
机构信息
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
出版信息
J Korean Assoc Oral Maxillofac Surg. 2014 Oct;40(5):211-9. doi: 10.5125/jkaoms.2014.40.5.211. Epub 2014 Oct 24.
OBJECTIVES
The purpose of this research was to create a scoring system that provides comprehensive assessment of patients with oromaxillofacial cancer or odontogenic infection, and to statistically reevaluate the results in order to provide specific criteria for elective tracheostomy.
MATERIALS AND METHODS
All patients that had oral cancer surgery (group A) or odontogenic infection surgery (group B) during a period of 10 years (2003 to 2013) were subgrouped according to whether or not the patient received a tracheostomy. After a random sampling (group A: total of 56, group B: total of 60), evaulation procedures were observed based on the group classifications. For group A, four factors were evaluated: TNM stage, reconstruction methods, presence of pathologic findings on chest posterior-anterior (PA), and the number of systemic diseases. Scores were given to each item based on the scoring system suggested in this research and the scores were added together. Similarly, the sum score of group B was counted using 5 categories, including infection site, C-reactive protein level on first visit, age, presence of pathologic findings on chest PA, and number of systemic diseases.
RESULTS
The scoring system rendered from this research shows that there is a high correlation between the scores and TNM stage in oral cancer patients, or infection sites in odontogenic infection patients. However, no correlation between pathologic findings on chest PA could be found in either group. The results also indicated that for both groups, the hospital day increased with the tracheostomy score. The tracheostomy score cutoff value was 5 in oral cancer patients and 6 in odontogenic infection patients which was used for elective tracheostomy indication.
CONCLUSION
The elective tracheostomy score system suggested by this research is a method that considers both the surgical and general conditions of the patient, and can be very useful for managing patients with severe oral disease.
目的
本研究的目的是创建一个评分系统，以全面评估口腔颌面部癌症或牙源性感染患者，并对结果进行统计学重新评估，以便为选择性气管切开术提供具体标准。
材料与方法
对10年期间（2003年至2013年）接受口腔癌手术（A组）或牙源性感染手术（B组）的所有患者，根据是否接受气管切开术进行亚组划分。随机抽样后（A组：共56例，B组：共60例），根据组分类观察评估程序。对于A组，评估四个因素：TNM分期、重建方法、胸部正位（PA）病理结果的存在情况以及全身疾病的数量。根据本研究建议的评分系统为每个项目打分，并将分数相加。同样，B组的总分使用5个类别计算，包括感染部位、首次就诊时的C反应蛋白水平、年龄、胸部PA病理结果的存在情况以及全身疾病的数量。
结果
本研究得出的评分系统表明，口腔癌患者的评分与TNM分期或牙源性感染患者的感染部位之间存在高度相关性。然而，两组中均未发现胸部PA病理结果之间存在相关性。结果还表明，对于两组患者，住院天数随气管切开术评分增加。口腔癌患者的气管切开术评分临界值为5，牙源性感染患者为6，用于选择性气管切开术指征。
结论
本研究提出的选择性气管切开术评分系统是一种同时考虑患者手术和一般状况的方法，对管理重症口腔疾病患者非常有用。
Zotero 插件