CAJ | 학술논문

目的：探讨口腔颌面部多间隙感染患者院内出现不良结局的相关危险因素。方法回顾性分析2005年1月至2015年1月我院收治的122例口腔颌面部多间隙感染患者的临床资料，对感染患者的病因分类及院内发生并发症的构成比进行收集统计，并对发生院内不良结局(住院时间延长及并发症)的相关危险因素进行单因素χ2检验、多元线性回归以及多因素Logistic回归分析。结果122例患者中有48例出现并发症，发生率为39.3%，122例患者以牙源性感染为主(70.5%)，其发生院内并发症的构成比为87.5%(42/48)，单因素分析中感染患者住院时间与合并系统性疾病、症状发作到入院时间、累及间隙数量、入院时血糖浓度、入院时白细胞计数及中性粒细胞百分比有关(P<0.05)，而并发症与年龄、合并系统性疾病、累及间隙数量、入院时血糖浓度、入院时白细胞计数及中性粒细胞百分比有关(P<0.05)；多元线性回归分析提示：合并全身系统性疾病、累及间隙数量、入院时血糖水平与住院时间呈正相关(P<0.05)，多因素Logistic回归分析显示：年龄(OR=1.580)、合并系统性疾病(OR=1.814)、累及间隙数量(OR=2.024)、入院时血糖浓度(OR=1.137)、入院时白细胞计数(OR=1.532)是口腔颌面部多间隙感染患者出现院内并发症的独立预测因素。结论口腔颌面部多间隙感染患者合并全身系统性疾病、累及间隙数量、入院时血糖浓度、入院时白细胞计数与治疗转归密切相关，临床应当针对这些高危因素加强干预治疗措施，积极扭转不良转归趋势以改善患者的预后。
목적：탐토구강합면부다간극감염환자원내출현불량결국적상관위험인소。방법회고성분석2005년1월지2015년1월아원수치적122례구강합면부다간극감염환자적림상자료，대감염환자적병인분류급원내발생병발증적구성비진행수집통계，병대발생원내불량결국(주원시간연장급병발증)적상관위험인소진행단인소χ2검험、다원선성회귀이급다인소Logistic회귀분석。결과122례환자중유48례출현병발증，발생솔위39.3%，122례환자이아원성감염위주(70.5%)，기발생원내병발증적구성비위87.5%(42/48)，단인소분석중감염환자주원시간여합병계통성질병、증상발작도입원시간、루급간극수량、입원시혈당농도、입원시백세포계수급중성립세포백분비유관(P<0.05)，이병발증여년령、합병계통성질병、루급간극수량、입원시혈당농도、입원시백세포계수급중성립세포백분비유관(P<0.05)；다원선성회귀분석제시：합병전신계통성질병、루급간극수량、입원시혈당수평여주원시간정정상관(P<0.05)，다인소Logistic회귀분석현시：년령(OR=1.580)、합병계통성질병(OR=1.814)、루급간극수량(OR=2.024)、입원시혈당농도(OR=1.137)、입원시백세포계수(OR=1.532)시구강합면부다간극감염환자출현원내병발증적독립예측인소。결론구강합면부다간극감염환자합병전신계통성질병、루급간극수량、입원시혈당농도、입원시백세포계수여치료전귀밀절상관，림상응당침대저사고위인소가강간예치료조시，적겁뉴전불량전귀추세이개선환자적예후。
Objective To explore the related risk factors for adverse outcome in patients with nosocomial in-fection in multiple spaces of oral and maxillofacial region. Methods A retrospective analysis of the clinical data of 122 patients with infection in multiple spaces of oral and maxillofacial region in our hospital from January 2005 to Jan-uary 2015 was performed. The constituent ratios of causes of infection and nosocomial complications were investigat-ed. Single factors chi-square test, multiple linear regression analysis and the multi-factor logistic regression analysis were performed for the related risk factors of the adverse outcomes (extended length of hospital stay and complica-tions). Results Among the 122 patients, 48 were found with complications, with the incidence of 39.3%. Most of (70.5%) of the 122 patients were tooth source infection, and the constituent ratio of the nosocomial complications was 87.5%(42/48). Single factor analysis showed that length of hospital stay was related to the combination of systemic disease, duration from symptom onset to admission, the number of interval involved, blood glucose level at admission, leukocyte count and neutrophil percentage at admission (P<0.05). The complications were related to the age, the sys-temic diseases and complications, the number of interval involved, blood glucose level at admission, leukocyte count and neutrophil percentage at admission (P<0.05). Multiple linear regression analysis showed that systemic disease, the number of interval involved, blood glucose level at admission and length of hospital stay were positively correlated (P<0.05). The multi-factor logistic regression analysis showed that age (OR=1.580), systemic diseases (OR=1.814), the number of interval involved (OR=2.024), blood glucose level at admission (OR=1.137), leukocyte count at admis-sion (OR=1.532) were the independent predictors of complications for patients with nosocomial infection in multiple spaces of oral and maxillofacial region. Conclusion For patients with nosocomial infection in multiple spaces of oral and maxillofacial region, the systemic diseases, the number of interval involved, blood glucose level at admission, leu-cocyte count at admission are closely related to treatment outcome. Clinically, we should strengthen intervention mea-sures according to the risk factors and control adverse outcomes in order to improve the prognosis of patients.