【作者】 李戍军；

【导师】 刘彦普；

【作者基本信息】 第四军医大学 ， 口腔临床医学， 2004， 硕士

【摘要】 随着我国现代化进程的不断提高，交通和工业事故逐年增加，已成为社会第一公害。创伤作为“发达社会疾病”日趋严重地威胁人类的健康，影响人口素质和生存质量。口腔颌面创伤在和平时期约占全身创伤的7％～20％，所以日益受到创伤工作者的重视。我国政府也非常重视创伤的防治与救护，已把相关研究列入“973”计划。关于颌面创伤流行病学研究国内报道较少，况且随着地域、人口、社会经济等因素不同，其流行病学研究结果也不尽相同，失去了它的科研对比价值。而且现有的创伤评分方法无法有效地评估颌面创伤严重度，因此，探讨一种更符合专科特点的颌面创伤评分方法是十分必要的。本研究目的就是通过大量临床病例资料的回顾性研究，确定西安及周边省市地区颌面创伤患者的流行病学特点，为颌面创伤的防治提供全面详细的流行病学资料；客观准确地评价颌面创伤严重度，使创伤的诊断、救治及判断愈后建立在更科学的基础上。此外，研制数据库软件，建立颌面创伤数据库，为今后能及时、准确、客观、动态地评价颌面创伤创造一个良好的和必备的基础。第四军医大学硕士学位论文1、领面创伤患者临床流行病学研究 目的通过大量临床病例资料的流行病学回顾性研究，明确西安及周边地区领面创伤患者的流行病学特点，为领面创伤的救治提供较为准确的流行病学资料信息。方法回顾调查第四军医大学口腔医学院1996年1月一2002年10月期间所有领面创伤住院患者，创建领面创伤数据库，对每例患者的年龄、性别、伤因、致伤机制、损伤的部位及特点、合并伤及治疗方法等内容逐一输入数据库，进行统计分析。结果共收录1159例，男性多于女性，男:女为3.95:1。交通损伤是主要伤因，共590例(59.92%)，其次暴力损伤221例(19.07%)，非明确原因跌落伤112例(9.66%)、职业损伤85例(7.33%)，运动损伤10例(0.86%)，医源性损伤7例(0.60%)。面下部是最容易受损伤的部位，下领骨骨折中颊部最多，其次为裸状突。四肢在合并伤中最多发，其次是颅脑和眼。结论应加强交通事故中领面损伤的防治，注意其多发伤的特点，进一步研究领面创伤的致伤机理及综合序列治疗方法及康复措施。2、三种创伤严重度评分对领面创伤评估的比较 目的研究并比较了三种领面创伤严重度评分方法，以便设计一种更符合口腔领面创伤专科特点的评分方法。方法从1159例领面创伤患者中选出院前时间蕊30天、病例资料完整的患者984例，分别以骨折处数和损伤部位分组，用155、RFISS和MISS法进行评分，用SPSSll.0统计软件分析。结果MISS法较RFISS法和155法更能准确地区分领面单处伤和多处伤。对不同部位的领面部损伤MISS法评估更有临床意义。结论从领面创伤功能损害的角度而言，MlsS法可以客观准确地评价领面创伤，并对治疗方法的选择和预后的评估更有临床指导意义。第四军医大学硕士学位论文3、领面创伤信息化系统的应用及评价(协作项目) 目的应用领面创伤数据库系统，以评价其科学性及实用性，以提高领面创伤信息化研究能力和水平。方法将第四军医大学口腔医学院1996年1月一2002年10月期间所有领面创伤住院患者，共1159例，分为两组。对每例患者的年龄、性别、伤因、致伤机制、损伤的部位及特点、合并伤及治疗方法等内容逐一输入数据库，进行回顾性和前瞻性应用研究，通过黑盒测试，评价及改进此系统。结果通过使用系统可将领面创伤患者的伤因、伤情、救治情况录入数据库，进行检索、统计分析和创伤评分研究:通过网络可实现领面创伤的资源共享和协作研究。结论该系统稳定性、安全性、兼容性可靠，专科特色明显，统计分析准确，可辅助通过网络收集标准化的创伤病例研究资料并进行合作科研研究。更多还原

【Abstract】 With the modernization in our country, traffic and industry accidents have increased greatly and been the first public danger. Trauma has heavily threatened our survival quality as the "modern social disease". The government has attached great importance to the prevention and treatment of trauma. It was listed as "national 973 Project". The percent of maxillofacial trauma accounts for about 7%~20% of the trauma in the peace times. The treatment of maxillofacial trauma has been paid more and more attention. The epidemiology study in maxillofacial trauma is less; moreover, demographic and social-economic factors greatly influence the results of the study. The purpose of the present study is to ascertain the epidemiological characteristics and provide detail data of maxillofacial trauma by retrospective study of a large number of clinic data in Xi’an and other areas around it. At the same time, we try to objectively and accurately estimate maxillofacial injury severity. It is significative in diagnosis prevention and restoration ofmaxillofacial injury. The present evaluation method can not effectively evaluate the severity of maxillofacial injury. So we try to probe into a method of maxillofacial injury score according to the specialty of maxillofacial trauma. Besides, we developed our database software and established oral and maxillofacial trauma database in order to evaluate maxillofacial injury objectively and accurately and dynamically.1 Survey of Epidemiological Characters of Maxillofacial InjuriesObjective: To analyse the epidemiological characteristics of maxillofacial injuries. Method: A retrospective review of maxillofacial trauma patients admitted to the Stomatology Hospital of Fourth Military Medical University from January, 1996 to October, 2002 was done. Data were collected on age, sex, etiology and mechanism of injury, location and clinical characters, associated injuries and treatment. Statistic analysis of the data was done. Results: 1159 patients were reviewed. The majority of victims were males. The male: female ratio was 3.95:1. RTA(road traffic accidents)was the major cause of facial injury, 590(59.92%), followed by assault (19.07%), falls(9.66%), Industrial accidents (7.33%).A large proportion of facial injuries occurred on the lower face. The symphysis of mandible was most frequently damaged, followed by condylar. The most common associated trauma was extremity fractures. Conclusion: Prevention and management of maxillofacial trauma in RTA should be strengthened and its characteristics of multiple injuries should be always be anticipated and identified. Further studies in the mechanism and integrative treatment measures of maxillofacial injury should be done.2 Comparison of Three Maxillofacial Injury Severity Score Methods in Evaluation of Maxillofacial TraumaObjective: To design a more reasonable method of evaluating maxillofacial injury severity by retrospective analysis. Method: 984 cases of maxillofacial trauma( <30 days before hospitalization) selected from 1159 cases were grouped by the number of fracture and site of trauma. They were evaluated with ISS, RFISS and MISS respectively. The results of ISS/RFISS/MISS were compared and analyzed with SPSS 11.0 software. Results: MISS could accurately differentiate between single and multiple facial injury. It is more meaningful for evaluating different sites of facial injury than ISS and RFISS. Conclusion: MISS can be used to evaluate maxillofacial injury objectively and accurately.3 The Application and Testing of Maxillofacial Trauma Database SystemObjective: To apply Maxillofacial Trauma Database System and evaluate the scientificalness and practicability of the system. Method: 1159 maxillofacial trauma patients’ data admitted to the Stomatology Hospital of Fourth Military Medical University from January, 1996 to October, 2002 were divided in two groups. By applying retrospective and prospective methods, data were inputed in the system, according to age, sex, etiology and mechanism of injury, location and clinical char更多还原