口腔疾病防治 ›› 2019, Vol. 27 ›› Issue (8): 510-514.DOI: 10.12016/j.issn.2096-1456.2019.08.007

• 临床研究 • 上一篇    下一篇

儿童口腔颌面部狗咬伤的治疗

张同韩1,刘晓玲2,吴纪楠1(),陈觉尧1,苏葵1,郑巧仪1   

  1. 1. 中山大学附属中山医院口腔分院口腔颌面外科,广东 中山(528403)
    2. 中山大学附属中山医院内科重症监护室,广东 中山(528403)
  • 收稿日期:2019-01-16 修回日期:2019-03-24 出版日期:2019-08-20 发布日期:2019-08-16
  • 通讯作者: 吴纪楠
  • 作者简介:张同韩,副教授,博士,Email:zthlove1982@163.com
  • 基金资助:
    中山市社会公益科技研究医疗重大专项(2017B1008)

Treatment of oral and maxillofacial dog bites in children

ZHANG Tonghan1,LIU Xiaoling2,WU Jinan1(),CHEN Jueyao1,SU Kui1,ZHENG Qiaoyi1   

  1. 1. Department of Stomatology, Affiliated Zhongshan Hospital of Sun Yat-sen University, Zhongshan 528400, China;
    2. Department of Medical Intensive Care Unit, Affiliated Zhongshan Hospital, Sun Yat-sen University, Zhongshan 528400, China.
  • Received:2019-01-16 Revised:2019-03-24 Online:2019-08-20 Published:2019-08-16
  • Contact: Jinan WU

摘要:

目的 总结儿童口腔颌面部狗咬伤的治疗经验,为临床提供参考。方法 对2011年7月—2018年6月期间收治的狗咬伤口腔颌面部的19例儿童患者行一期清创缝合,同时给予狂犬病疫苗、破伤风疫苗及被动免疫制剂人源免疫球蛋白肌肉注射,并使用阿莫西林克拉维酸钾等抗炎治疗,并进行随访及回顾性分析。结果 19例儿童患者,经过治疗后18例一期愈合,1例二期愈合,随访半年至7年半,患儿面容恢复较好、未发生狂犬病。结论 对于狗咬伤口腔颌面部患儿的治疗,一期清创缝合减轻了术后瘢痕,有利于面容的恢复。

关键词: 狗咬伤, 颌面部外伤, 儿童, 清创术, 一期缝合, 狂犬病, 疫苗, 被动免疫制剂

Abstract:

Objective To summarize experience treating dog bites in the oral and maxillofacial regions of children and provide a reference for clinical practice. Methods Nineteen children with dog bite wounds in the maxillofacial region were treated from July 2011 to June 2018 with primary debridement and suturing. A rabies vaccine, tetanus vaccine and human immunoglobulin as a passive immune agent were given via intramuscular injection. Anti-inflammatory therapy with amoxicillin and clavulanate potassium or other antibiotics. Follow-up observation and a retrospective analysis of the treatment effect were carried out. Results After treatment, among the 19 pediatric patients, 18 cases showed primary healing and 1 case showed secondary healing. The follow-up period ranged from six months to seven and a half years. No cases of rabies occurred. Conclusion For the treatment of patients with maxillofacial dog bite wounds, the first stage debridement and suture can reduce the scar after operation and is beneficial to the recovery of face.

Key words: dog bite, facial trauma, children, wound debridement, primary suture, rabies, vaccine, passive immunization

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