重伤患者的颌面损伤
Maxillofacial injuries in severely injured patients.
作者信息
Scheyerer Max J, Döring Robert, Fuchs Nina, Metzler Philipp, Sprengel Kai, Werner Clement M L, Simmen Hans-Peter, Grätz Klaus, Wanner Guido A
机构信息
Department of Surgery, Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zürich, Switzerland.
Division of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland.
出版信息
J Trauma Manag Outcomes. 2015 Jun 9;9:4. doi: 10.1186/s13032-015-0025-2. eCollection 2015.
BACKGROUND
A significant proportion of patients admitted to hospital with multiple traumas exhibit facial injuries. The aim of this study is to evaluate the incidence and cause of facial injuries in severely injured patients and to examine the role of plastic and maxillofacial surgeons in treatment of this patient collective.
METHODS
A total of 67 patients, who were assigned to our trauma room with maxillofacial injuries between January 2009 and December 2010, were enrolled in the present study and evaluated.
RESULTS
The majority of the patients were male (82 %) with a mean age of 44 years. The predominant mechanism of injury was fall from lower levels (<5 m) and occurred in 25 (37 %) cases. The median ISS was 25, with intracranial bleeding found as the most common concomitant injury in 48 cases (72 %). Thirty-one patients (46 %) required interdisciplinary management in the trauma room; maxillofacial surgeons were involved in 27 cases. A total of 35 (52 %) patients were treated surgically, 7 in emergency surgery, thereof.
CONCLUSION
Maxillofacial injuries are often associated with a risk of other serious concomitant injuries, in particular traumatic brain injuries. Even though emergency operations are only necessary in rare cases, diagnosis and treatment of such concomitant injuries have the potential to be overlooked or delayed in severely injured patients.
背景
因多处创伤入院的患者中有很大一部分存在面部损伤。本研究的目的是评估重伤患者面部损伤的发生率及原因，并探讨整形颌面外科医生在这类患者群体治疗中的作用。
方法
本研究纳入了2009年1月至2010年12月间被送至我院创伤室、伴有颌面损伤的67例患者并进行评估。
结果
大多数患者为男性（82%），平均年龄44岁。主要致伤机制为从较低高度（<5米）坠落，共25例（37%）。损伤严重度评分（ISS）中位数为25，48例（72%）最常见的合并伤为颅内出血。31例患者（46%）在创伤室需要多学科管理，其中27例有颌面外科医生参与。共有35例（52%）患者接受了手术治疗，其中7例为急诊手术。
结论
颌面损伤常伴有其他严重合并伤的风险，尤其是创伤性脑损伤。尽管急诊手术仅在少数情况下必要，但在重伤患者中，此类合并伤的诊断和治疗可能被忽视或延误。
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