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目的:探讨口腔颌面部急性炎症期病变的手术治疗原则和方法。方法:2009年1月～2010年12月武汉总医院口腔颌面外科收治颌面颈部急性化脓性炎症125例,其中淋巴结脓肿45例、囊肿伴感染35例、间隙感染24例、化脓性颌下腺炎10例、良性肿瘤伴感染5例、淋巴瘤病变6例。94例行脓肿及包块整体切除术、严密关闭手术创,部分伤口置负压引流;31例行脓肿切开引流术,伤口内置半管或橡皮片引流。术后均进行常规抗炎治疗。结果:94例急性期包块整体切除后,患者全身发热、不适等症状明显好转,局部炎症反应在1～3天内控制,伤口大部分一期愈合。脓肿切开引流者,伤口持续渗出和反复换药,愈合延迟10天以上。结论:口腔颌面部急性炎症期包块大部分可以同期整体切除并严密关闭创口,少数病例只能行脓肿切开引流术。
Objective: To investigate the surgical treatment principles and methods of the acute inflammation in oral and maxillofacial region. METHODS: From January 2009 to December 2010, 125 cases of maxillofacial acute suppurative inflammation were treated in Department of Oral and Maxillofacial Surgery, Wuhan General Hospital. Among them, 45 cases were lymph node abscess, 35 cases were cyst accompanied by infection, 24 cases were interstitial infection and suppurative submandibular gland 10 cases of inflammation, 5 cases of benign tumor associated with infection, 6 cases of lymphoma. 94 cases of abscess and mass resection, close the surgery, some of the wound set negative pressure drainage; abscess incision and drainage in 31 cases, the wound built-in half tube or rubber sheet drainage. Postoperative routine anti-inflammatory treatment. Results: After the whole resection of 94 cases of acute mass, the symptoms of systemic fever and discomfort were obviously improved. The local inflammatory reaction was controlled within 1 to 3 days and most of the wound healed in one time. Abscess incision and drainage, the wound continued to ooze and repeated dressing, healing delayed more than 10 days. Conclusion: Most of the maxillofacial acute inflammatory phase mass can be resected in the same period and the wounds can be closed tightly. In a few cases, abscess incision and drainage can be performed only.