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儿童牙源性感染的管理:一项回顾性临床研究。

Management of odontogenic infection in paediatric patients: a retrospective clinical study.

作者信息

Lim Sarah Wan-Lin, Lee Wei Shiu, Mani Shani Ann, Kadir Kathreena

机构信息

Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.

Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.

出版信息

Eur Arch Paediatr Dent. 2020 Feb;21(1):145-154. doi: 10.1007/s40368-019-00466-0. Epub 2019 Jul 22.

Abstract

PURPOSE

To investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital.

METHODS

A retrospective study (2013-2015) was carried out which involved retrieving relevant data from past records (manual/electronic) of paediatric patients (under 18-years-old) who presented with odontogenic infections to the Paediatric Dentistry and Oral and Maxillofacial clinic. Data collected was organised using descriptive statistics with SPSS version 12.0.1.

RESULTS

A total of 153 patients were identified, of which 83.7% were managed as outpatients. Odontogenic infections were more common in females (52.9%) and preschool children (58.2%). The most cases were seen in 2014 and maximum number of cases per month was 12. Common presentations were pain (62.1%), intraoral swelling (37.9%) and spontaneous pus discharge from the tooth and/or surrounding tissues (67.3%) with higher involvement of primary right molars. Dental panoramic tomograph was the most common radiographic investigation done. Outpatients were commonly managed chairside with pulpal opening (46.1%) at the paediatric dental clinic and 7% underwent extraction under general anaesthesia in day-care setting. Inpatients were admitted for 3 days on average and most commonly definitive care was extraction under local/general anaesthesia (68%). There were 22.7% outpatients and 72.0% inpatients who were prescribed antibiotics.

CONCLUSIONS

Overall, treatment and medications prescribed adhered to current guidelines. There was a tendency to solely prescribe antibiotics in 8.6% of outpatients which is contrary to recommendations.

摘要

目的

调查在一家大学医院就诊的儿科患者牙源性感染的门诊和住院治疗情况。

方法

开展一项回顾性研究(2013 - 2015年),从儿科牙科及口腔颌面诊所的儿科患者(18岁以下)既往记录(手工/电子)中检索相关数据。收集的数据使用SPSS 12.0.1版进行描述性统计整理。

结果

共识别出153例患者,其中83.7%作为门诊患者进行治疗。牙源性感染在女性(52.9%)和学龄前儿童(58.2%)中更为常见。2014年病例最多,每月最多病例数为12例。常见症状为疼痛(62.1%)、口腔内肿胀(37.9%)以及牙齿和/或周围组织自发排脓(67.3%),其中右上第一磨牙受累较多。牙科全景断层扫描是最常用的影像学检查。门诊患者通常在儿科牙科诊所椅旁进行牙髓开放治疗(46.1%),7%的患者在日间护理环境下接受全身麻醉拔牙。住院患者平均住院3天,最常见的确定性治疗是在局部/全身麻醉下拔牙(68%)。22.7%的门诊患者和72.0%的住院患者使用了抗生素。

结论

总体而言,治疗和用药符合现行指南。8.6%的门诊患者有单纯使用抗生素的倾向,这与建议相悖。

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