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下颌骨骨折手术治疗中影响并发症的危险因素分析:一项回顾性研究。

Analysis of the risk factors influencing complications in surgical treatment of mandibular fractures: A retrospective study.

作者信息

Kong Tae Hyun, Chung Kyu Jin, Kim Yong Ha

机构信息

Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, South Korea.

Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, South Korea.

出版信息

J Craniomaxillofac Surg. 2022 Dec;50(12):929-933. doi: 10.1016/j.jcms.2022.12.001. Epub 2022 Dec 28.

Abstract

The study aim was to identify risk factors associated with complications following open reduction and internal fixation of mandibular fractures. A retrospective cohort study was conducted in patients who were treated for mandibular fractures in a single center between January 2010 and December 2020. Authors classified postoperative complications as overall complications, infections, and reoperations. Factors that may be associated with these complications were grouped as patient, wound, and management variables. Statistical analysis was performed to determine whether these factors influenced complications. Among 175 patients, 125 underwent open reduction and internal fixation. Among patient variables, alcohol consumption was a risk factor for overall complications (p = 0.03) and reoperation (p = 0.02). Among wound variables, the more severe the external wound, the greater the incidence of overall complications (p = 0.001) and infections (p < 0.001). Presence of two or more fracture sites was a risk factor for reoperation (p = 0.038). Among management variables, intraoral and extraoral approaches increased the rates of overall complications, infections, and reoperation. In the multivariate analysis, only intraoral and extraoral approaches were associated with significant risks for overall complications (OR = 5.63, p = 0.017) and infections (OR = 11.53, p = 0.005). Alcohol consumption, external wound severity, multiple fracture site, and incision approach were related to postoperative complications. These findings can help guide surgical decisions and manage patient expectations after surgery.

摘要

本研究的目的是确定下颌骨骨折切开复位内固定术后并发症的相关危险因素。对2010年1月至2020年12月在单一中心接受下颌骨骨折治疗的患者进行了一项回顾性队列研究。作者将术后并发症分为总体并发症、感染和再次手术。可能与这些并发症相关的因素分为患者、伤口和管理变量。进行统计分析以确定这些因素是否会影响并发症。在175例患者中,125例行切开复位内固定术。在患者变量中,饮酒是总体并发症(p = 0.03)和再次手术(p = 0.02)的危险因素。在伤口变量中,外部伤口越严重,总体并发症(p = 0.001)和感染(p < 0.001)的发生率越高。存在两个或更多骨折部位是再次手术的危险因素(p = 0.038)。在管理变量中,口内和口外入路增加了总体并发症、感染和再次手术的发生率。在多变量分析中,只有口内和口外入路与总体并发症(OR = 5.63,p = 0.017)和感染(OR = 11.53,p = 0.005)的显著风险相关。饮酒、外部伤口严重程度、多处骨折部位和切口入路与术后并发症有关。这些发现有助于指导手术决策并管理患者术后的期望。

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