CAJ | 학술논문

目的：评估感染下颌骨骨折内固定的临床疗效。方法对2000-2008年间两家三甲医院感染下颌骨骨折内固定的患者临床疗效、手术处置、细菌学检查及抗生素使用情况进行回顾性分析。根据感染部位将下颌骨骨折患者分为软组织感染及骨组织感染两组。结果31例感染下颌骨折患者术后随访12个月，软组织感染下颌骨骨折治愈率100%，骨组织感染亚组治愈率85%；分离出病原菌22株，其中革兰阳性球菌16株，革兰阴性杆菌6株。革兰阳性球菌对万古霉素、替考拉宁敏感率达100%，革兰阴性杆菌对亚胺培南、美罗培南敏感率达100%。患者术后全部使用抗生素。结论感染区切开引流灌洗、骨清创、骨折复位、坚强内固定、足量抗生素的临床治疗程序可有效治疗感染下颌骨骨折。
목적：평고감염하합골골절내고정적림상료효。방법대2000-2008년간량가삼갑의원감염하합골골절내고정적환자림상료효、수술처치、세균학검사급항생소사용정황진행회고성분석。근거감염부위장하합골골절환자분위연조직감염급골조직감염량조。결과31례감염하합골절환자술후수방12개월，연조직감염하합골골절치유솔100%，골조직감염아조치유솔85%；분리출병원균22주，기중혁란양성구균16주，혁란음성간균6주。혁란양성구균대만고매소、체고랍저민감솔체100%，혁란음성간균대아알배남、미라배남민감솔체100%。환자술후전부사용항생소。결론감염구절개인류관세、골청창、골절복위、견강내고정、족량항생소적림상치료정서가유효치료감염하합골골절。
Objective To evaluate the treatment outcomes of rigid internal ifxation for the management of infected mandible fractures. Methods A retrospective study of infected mandible fractures managed by a single oral and maxilloifcal surgeon at two level 1 trauma center during a 9-year period was accomplished by independent examiners. All paitients were treated with incison and drainage , culture and sensitivity testing, fracture reduction with bone debridement and decortication, rigid internal ifxation of the mandible by an extraoral approach ,and antibiotic therapy. The whole fracture was classiifed into 2 groups:those with soft tissue infections in the fracture region versus those with hard tissue infected fratures. Results A total of 31 patient were included in this study ,with an average follow-up of 12 months from the date of surgery (range 3 to 36). The treatment protocol was successful in all 19 patients (100%) with soft tissue infected mandibular fractures and 10 (85%) of 12 patients with hard tissue-infected fractures. Conclusion A protocol consisting of concomitant incision and drainage, mandibular debridement ,fracture reduction, and stabilization with rigid internal ifxation can be effectively used for single-stage management of infected mandible fratures.