Opitz Daniel, Camerer Christian, Camerer Doris-Maria, Raguse Jan-Dirk, Menneking Horst, Hoffmeister Bodo, Adolphs Nicolai
Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
J Craniomaxillofac Surg. 2015 Mar;43(2):285-9. doi: 10.1016/j.jcms.2014.12.002. Epub 2014 Dec 6.
The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed. Surgical treatment consisted in incision and drainage of the abscess supported by additional i.v. antibiotic medication in all patients. Detailed analysis of all patients that required postoperative intensive medical care was additionally performed with respect to special risk factors. During 8 years 814 patients affected by odontogenic infections received surgical treatment under stationary conditions representing 4% of all patients that have been treated during that period (n = 18981). In 14 patients (1.7%) intensive medical therapy after surgery was required, one lethal outcome was documented (0.12%). In all of these 14 patients a history of typical risk factors was present. According to these results two patients per week affected by an odontogenic infection required stationary surgical treatment, about two patients per year were likely to require additional intensive medical care. If well-known risk factors are present in patients affected by odontogenic infection appropriate interdisciplinary management should be considered as early as possible.
牙源性感染的处理是颌面外科领域的典型工作内容。通常情况下,这些感染能够以直接的方式得到处理,然而在某些条件下,可能会出现严重且复杂的病程,这就需要包括重症监护在内的多学科治疗。对2004年至2011年期间在住院条件下接受手术治疗的所有牙源性感染患者进行了回顾性分析。手术治疗包括脓肿切开引流,并在所有患者中辅以静脉注射抗生素药物。此外,针对特殊风险因素,对所有需要术后重症医疗护理的患者进行了详细分析。在8年期间,814例牙源性感染患者在住院条件下接受了手术治疗,占该时期所有接受治疗患者的4%(n = 18981)。14例患者(1.7%)术后需要重症医疗治疗,记录到1例死亡病例(0.12%)。在所有这14例患者中,均存在典型风险因素病史。根据这些结果,每周约有2例牙源性感染患者需要住院手术治疗,每年约有2例患者可能需要额外的重症医疗护理。如果牙源性感染患者存在已知的风险因素,应尽早考虑适当的多学科管理。