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重症监护中颌面创伤的全球负担:流行病学、预防、经济学及结局的叙述性综述

The Global Burden of Maxillofacial Trauma in Critical Care: A Narrative Review of Epidemiology, Prevention, Economics, and Outcomes.

作者信息

Maniaci Antonino, Lentini Mario, Vaira Luigi, Lavalle Salvatore, Ronsivalle Salvatore, Rubulotta Francesca Maria, Lentini Lepanto, Paternò Daniele Salvatore, Galletti Cosimo, Sorbello Massimiliano, Lechien Jerome R, La Via Luigi

机构信息

Department of Medicine and Surgery, University of Enna "Kore", 94100 Enna, Italy.

ASP Ragusa, 97100 Ragusa, Italy.

出版信息

Medicina (Kaunas). 2025 May 18;61(5):915. doi: 10.3390/medicina61050915.

Abstract

: Maxillofacial trauma represents a significant global health challenge with substantial physical, psychological, and socioeconomic consequences. This narrative review analyzed 112 articles published between 2000 and 2024 examining epidemiology, prevention, economics, and outcomes of maxillofacial trauma in critical care settings. : Road traffic accidents remain the primary cause globally, followed by interpersonal violence and occupational injuries. Effective prevention strategies include seat belt laws, helmet legislation, and violence prevention programs. Economic burden encompasses direct healthcare costs (averaging USD 55,385 per hospitalization), productivity losses (11.8 workdays lost per incident), and rehabilitation expenses (USD 3800-18,000 per patient). Surgical management has evolved toward early intervention, minimally invasive approaches, and advanced techniques using computer-aided design and 3D printing. Complications affect 3-33% of patients, with significant functional disabilities and psychological sequelae (post-traumatic stress disorder in 27%, depression/anxiety in 20-40%). : Maxillofacial trauma management requires multidisciplinary approaches addressing both immediate treatment and long-term rehabilitation. Despite technological advances, disparities in specialized care access persist globally. Future efforts should implement evidence-based prevention strategies, reduce care disparities, and develop comprehensive approaches addressing physical, psychological, and socioeconomic dimensions through collaboration among healthcare professionals, policymakers, and community stakeholders.

摘要

颌面创伤是一项重大的全球健康挑战,会带来严重的身体、心理和社会经济后果。本叙述性综述分析了2000年至2024年间发表的112篇文章,这些文章研究了重症监护环境中颌面创伤的流行病学、预防、经济学和治疗结果。全球范围内,道路交通事故仍然是主要原因,其次是人际暴力和职业伤害。有效的预防策略包括安全带法律、头盔立法和暴力预防计划。经济负担包括直接医疗费用(每次住院平均55385美元)、生产力损失(每次事故损失11.8个工作日)和康复费用(每位患者3800 - 18000美元)。手术管理已朝着早期干预、微创方法以及使用计算机辅助设计和3D打印的先进技术发展。3% - 33%的患者会出现并发症,伴有严重的功能残疾和心理后遗症(27%患有创伤后应激障碍,20% - 40%患有抑郁/焦虑症)。颌面创伤管理需要多学科方法,既要解决即时治疗问题,也要关注长期康复。尽管有技术进步,但全球在获得专科护理方面仍存在差距。未来的努力应实施基于证据的预防策略,减少护理差距,并通过医疗保健专业人员、政策制定者和社区利益相关者之间的合作,制定全面的方法来解决身体、心理和社会经济方面的问题。

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