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牙源性感染的频率和严重程度不断增加,需要住院治疗和手术处理。

Increasing frequency and severity of odontogenic infection requiring hospital admission and surgical management.

作者信息

Fu B, McGowan K, Sun J H, Batstone M

机构信息

School of Medicine, University of Queensland, Herston, Queensland 4029, Australia.

School of Dentistry & Oral Health, Gold Coast Campus, Griffith University, Queensland 4222, Australia.

出版信息

Br J Oral Maxillofac Surg. 2020 May;58(4):409-415. doi: 10.1016/j.bjoms.2020.01.011. Epub 2020 Jan 25.

Abstract

Odontogenic infections can become life-threatening if not managed in a timely manner, and they increase the physical cost of treatment to the patient and the financial cost to the public health system. We investigated the number of admissions to a Queensland tertiary hospital within a decade, and differences in the patients' characteristics, severity at presentation, and clinical outcomes. We compared patients with odontogenic infections who were taken to theatre at the Royal Brisbane & Women's Hospital (RBWH) between January 2003 and December 2004 with those treated between January 2013 and December 2014, a total of 292. Data on demographics, presentation, previous history, antimicrobial treatment, and admissions, were collated and analysed. There were no significant differences in demographics. In the 2013/2014 group there was a two-fold increase in infections related to lower third molars (p=0.001), a 50% increase in trismus (p=0.001), and a 20% increase in submandibular swelling (p=0.010). The percentage of patients admitted to the intensive care unit (ICU) was three and a half times higher in the 2013/2014 group (p=0.001). The presentation of odontogenic infections has increased in the decade from 2003/2004 to 2013/2014. Measures of the severity of disease have increased, while the basic characteristics of the patients have remained constant. Improved primary preventative measures and early interventions are therefore needed to alleviate the burden that these infections place on the public health system.

摘要

牙源性感染若不及时处理,可能会危及生命,还会增加患者的治疗成本以及公共卫生系统的经济负担。我们调查了昆士兰一家三级医院十年内的收治人数,以及患者特征、就诊时的严重程度和临床结果的差异。我们将2003年1月至2004年12月间在皇家布里斯班妇女医院(RBWH)接受手术治疗的牙源性感染患者与2013年1月至2014年12月间接受治疗的患者进行了比较,共计292例。收集并分析了人口统计学、就诊情况、既往病史、抗菌治疗和住院情况等数据。人口统计学方面无显著差异。在2013/2014组中,与下颌第三磨牙相关的感染增加了两倍(p = 0.001),牙关紧闭增加了50%(p = 0.001),颌下肿胀增加了20%(p = 0.010)。2013/2014组入住重症监护病房(ICU)的患者比例高出3.5倍(p = 0.001)。从2003/2004年到2013/2014年的十年间,牙源性感染的就诊人数有所增加。疾病严重程度指标有所上升,而患者的基本特征保持不变。因此,需要改进一级预防措施和早期干预,以减轻这些感染给公共卫生系统带来的负担。

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