口腔頜面部損傷

口腔頜面部損傷Dr.SteveGFShenOralandMaxillofacialSurgerySchoolofStomatologyShanghaiNinthPeople’sHospitalShanghaiSecondMedicalUniversityOral&MaxillofacialTraumaChapter712/13/20221Vocabularyabrasion擦傷adjacenttooth鄰牙alar鼻翼的antibiotics抗生素anti-infection抗感染anuria無尿archbar牙弓夾板arterial動(dòng)脈的asphyxia窒息bandage綁帶bitewound咬傷bloodsupply血供bustup斗毆capillary毛細(xì)血管的cerebral腦的cerebralfluid腦脊液cervical頸的concussion震蕩contaminate污染contusion挫傷12/13/20222Vocabularycyanosis發(fā)紺debridement清創(chuàng)術(shù)alveolarprocess齒槽突dentalpulp牙髓devitalize失活dysfunction功能異常dysphoria煩躁不安edema水腫esthetic美學(xué)的exfoliate脫落exsanguine失血的extradural硬腦膜外的extrinsicforce外力extrusion突出的facialnerve面神經(jīng)foreignbody異物fracture骨折gingival牙齦的hematoma血腫hemostasia止血，止血法12/13/20223Vocabularyhemostat止血鉗hyponuria少尿hypopnea低通氣incisedwound切割傷inhale吸氣inspiratoryasphyxia吸入性窒息intracranial顱內(nèi)的intubation插管lacerate撕裂laceration撕裂ligation結(jié)扎luxation脫位malocclusion咬合錯(cuò)亂mandible下頜骨mastication咀嚼m(xù)axilla上頜骨maxillofacial頜面的mouthopening張口度nasalcavity鼻腔obliviscence遺忘12/13/20224Vocabularyobstructiveasphyxia阻塞性窒息occlusion咬合oralcavity口腔oralhygiene口腔衛(wèi)生orbit眼眶pain-killer止痛劑paralysis癱瘓paranasalsinus副鼻竇parotidgland腮腺percussion叩診periodontalligament牙周韌帶petechia瘀斑，瘀點(diǎn)pharyngealcavity咽腔plasma血漿psychological心理的psychotherapy精神療法rabies狂犬病regenerate再生reimplantation再植rescue營(yíng)救，搶救12/13/20225Vocabularyrespiratory呼吸的saliva涎液，唾液salivary涎液的shock休克skullbase顱底stomatognathic口頜的subdermal皮下的swallow吞咽sweat出汗tetanus破傷風(fēng)toothache牙疼toxicshock中毒性休克transportation運(yùn)輸，搬運(yùn)trauma損傷，外傷trigeminalnerve三叉神經(jīng)unconsciousness神志不清upperairway上呼吸道vaccination接種疫苗venous靜脈的viscera內(nèi)臟12/13/20226Definitionoftraumatrauma

noun[CorU]severeemotionalshockandpaincausedbyanextremelyupsettingexperience:

thetraumaofmarriagebreakdown

Hehadpsychotherapytohelphimdealwithhischildhoodtraumas.SPECIALIZEDasevereinjury,usuallycausedbyaviolentattackoranaccident(fromCambridgeAdvancedLearner'sDictionary)12/13/20227Section1IntroductionWarIncidenceTrafficAccidentSportsFallingBustupLaborinjury12/13/2022824萬14.2萬人10億元1993年1997年2001年30萬19萬人18.5億元75.5萬54.6萬人3.09bRMBFinancialLoss致傷人數(shù)NooftrafficaccidentTrafficAccident12/13/20229TrafficAccident12/13/202210Combinedinjurytootherviscera-FataltolifeDamagetomaxillofacialstructureStomatognathicdysfunctionFacialestheticproblemPsychologicaltraumaEffectofTraumaontheHumanBody12/13/2022111.RichbloodsupplySection2CharacteristicsofOMFTrauma12/13/202212DebridementTime:24–48hTendto hematoma,edemaRespiratorytractAsphyxiaAbilitytoanti-infection,regenerationWoundhealing1.Richbloodsupply12/13/202213CerebralconcussionCerebralcontusionIntracranialhematomaSkullbasefractureIncreaseinfectiousincidenceMalocclusioncaused-DiagnosisOcclusionregained-Treatment2.Relationshipbtwtooth&OMFtrauma3.Cranio-cerebraltrauma12/13/202214Mouthopening,mastication,swallowing4.Cervicaltrauma5.Effectonbreathing6.EffectofondigastricsystemBleedingParalysis 癱瘓LeadingdifficultybreathingdietworseoralhygieneAsphyxia窒息12/13/2022157.Multi-sinus -contaminationInfectionOralcavityNasalcavityPharyngealcavityOrbitParanasalsinusBacteriaTempHumidity12/13/2022168.DamagetospecificstructureParotidGlandFacialN.TrigeminalN.SalivaryfistulaFacialparalysisRegionalnumbness12/13/2022179.FacialDefectFacialcontourPsychologicaltrauma12/13/202218EvaluatetraumasoonIdentifythekeytrauma,managethefatalfirstCarefulhistorytaking,thoroughphysicalexamRescueintimeManagementinorderGeneralRulesSection3Rescue12/13/2022191.PreventionofAsphyxiaSection3Rescue12/13/202220Dysphoria,sweating,inhalingrespirationDifficulttoinhale,hypopnea,nasalalarmovement,labialcyanosisThreeconcavesigns、Rapidbreathing,weakpulse,decreasedBPPupilsdiluted,Noreflectiontolight1.1ClinicalfeaturesofasphyxiaProdrome12/13/2022211.2EtiologyofAsphyxiaForeignbodyobstructionInspiratoryAsphyxiaLowAirwaySwellingForeignbodyBlood,salivaVomitUpperairwayTissuedislocationObstructiveAsphyxia12/13/2022221.3RescueofAsphyxiaClearforeignbodyinupperairwaySuspendmaxillaIntubationHoldthetongueoutObstructiveAsphyxia吸入性窒息氣管切開術(shù)12/13/2022232.HemostasiaTwosteps：JudgebleedingsituationChoosethewaytostopbleedingSection3Rescue12/13/2022242.1JudgebleedingsituationThreecategoriesArterialCapillaryVenousBasedonorigin12/13/202225壓迫止血指壓止血法包扎止血法填塞止血法結(jié)扎止血法藥物止血法2.2Methodsofhemostat12/13/2022263.Anti-shocktreatment(2)Purposeofanti-shock(1)Definition&ClassificationTraumaticshockExsanguineshock

>20%BodyweightToxicshockInfectiousshockRestorecirculation12/13/202227(4)PrinciplesofTreatment(3)FeaturesofShockEarlystage:Dysphoria,quick&superficialbreath,sweating,palenessMiddlestage:Tingletosupression,emotionalfaint,unconsciousness,decreaseBP,labialpalenessLatestage:weakerpulsation,unmeasurableBP,hyponuria,anuria<30ml/hHemostasis,bloodtransfusion,paincontrol,fluidtransfusion,sedation12/13/202228(1)Judgement4.CombinedCraniocerebralInjuriesConsciousness,pulse,BP,respiration,pupil(2)Earlydiscovery,earlymanagementRetrogradeobliviscence CerebralconcussionIntermediatewake-up ExtraduralhematomaCerebralfluidleak Skullbasefracture12/13/20222912/13/202230DebridementWoundclosureAntibiotics5.PreventionofInfection6.Bandage&Transportation12/13/202231

Section4SoftTissueTrauma12/13/202232Abrasions 擦傷Contusions 挫傷Contusions&Lacerations 挫裂傷Incised&PunctureWound 切割傷及刺傷BiteWound 咬傷TypesofinjuriesSection4SoftTissueTrauma12/13/202233Character:Irregularwoundedge,foreignbody,pain,oozing&yellowishplasmaoozingManagement:Debridement,removeforeignbody,Drywound,drainwheninfected1.AbrasionsProperty:roughsurfaceEpidermis&superficialdermis12/13/2022341.Abrasions12/13/2022352.ContusionsCharater:petechia,swelling,painManagement:

HemostasisPain-killerPreventionofinfectionHematomaresorptionRe-establishmentoffunctionProperty:bluntmaterial&felltohardobjectSubdermaltissue(noopenwound)12/13/202236Property:Bluntobjectwithhighmechanicalforce3.Contusions&LacerationsCharacterIrregularwoundedge,saw-toothedBiglacerationw/wonecrotictissue&openfracturesManagementDebridementWoundClosureSofttissue12/13/2022373.Contusions&Lacerations12/13/202238Property:Sharpobjectorinstruments4.Incised&PunctureWoundCharater

RegularwoundedgeBleedingSmallaccess,butdeepwoundManagementDebridementWoundclosureSofttissue12/13/202239Property:Animal(Wolf,dog,Bear)orhumanbeingsCharacterToothtracedHeavycontaminationTendtoinfectionManagementThoroughdebridementInfectioncontrolSkingraftaftergranulartissueregeneratedVaccinationofTetanus,Rabies5.BiteWound12/13/202240DefinitionDebridement

MainEntry:de·bride·ment

Pronunciation:di-'brEd-m&nt,dA-,-"m?nt,dA-brEd-'m?n

Function:

noun

Etymology:Frenchdébridement,fromdébridertoremoveadhesions,literally,tounbridle,fromMiddleFrenchdesbrider,fromdes-de-+bridebridle,fromMiddleHighGermanbrIdel--moreatBRIDLE

:thesurgicalremovaloflacerated,devitalized,orcontaminatedtissue12/13/202241Protocol1.washwoundTime：6--12hSolution:soapwater,saline,hydrogendioxideDebridement3.Closure2.CleanwoundRemovalofforeignbody Trimmingofnecrotictissue12/13/20224212/13/202243CheekinjuriesPalateinjuriesInjuriesatotherregionsManagementofsofttissureinjuriesTongueinjuriesLengthmaintain,longitudinalclosureIndependentclosure,buttonguesuturedominationBigneedlewithbig,depthsuturingormatricsuturing12/13/202244Managementofsofttissureinjuries12/13/20224512/13/202246Section5InjuryofTeethandDentalAlveolarProcess12/13/2022471.Toothinjuries1.1ContusionofTeethEtiology:Extrinsicforce blunttoothinjuries

PeriodontalligamentsordentalpulpCharacter:ExtrusionoftoothMobilityPercussion&ToothachewhenchewingManagementToothrestToothgroundSimpleligation12/13/2022481.Toothinjuries1.2LuxationofTeethClassificationCharacterToothdislocatedorexfoliatedManagementToothprotectionpriorityReductionFixationReimplantationPartialluxationCompleteluxation-Toothdislocation-Semiluxation-Intrusivemovement12/13/202249Gingivalorlabialswelling,lacerationAdjacentteethoralveolarprocessmovementwhenoneaffectedtoothtouchedFragmentdislocation,MalocclusionInaccordancewithtoothluxationorfracture2.FractureofAlveolarProcessCharacters12/13/202250Extrinsicforcetodentalalveolarprocess,mainlytoupperjawReductionunderLAArchbarapplied2.FractureofAlveolarProcessEtiologyManagement12/13/2022512.FractureofAlveolarProcess12/13/202252Stainlesssteelwireligation,Archbars12/13/202253QuestionsDescribethecharacteristicsofOMFTrauma?Describetheetiology,clinicalfeaturesandmanagementofasphyxia.Describethewaysofhemastasis.Whatisdebridement?Describethecommonsiteofdentalalveolarprocessfracture,andtheirclinicalmanifestation.12/13/202254ReferenceLJPeterson,etal:ContemporaryOral&MaxillofacialSurgery.4thed.Mosby.Missorri.2003WBooth,etal:MaxillofacialSurgery.Vol1,2.1sted.ChurchillLivingstone.London.1999邱蔚六主編.口腔頜面外科學(xué).第5版.人民衛(wèi)生出版社.200412/13/202255THEEND12/13/202256l8$F8wCoV#zJhiKomzZn!x0yY1-M34KTsw!MR4Fg-UFn-)LHYtrUN9aWag6UpZnXt7-5v9dKG23M)CUgWye&HcGWUxWSijPXF1da*HfUs5HJu(a-spULD(4*JcI1uH3oujW0Jjt5ogWpimzR0e30aBor3m6psm!cgtN4yEe*YEfFGe5sjPN$rrBDz463#*Ap)uwur$xLaFMI1fs&%29DL1KUf73rumS6q%PzjOdpfLxV6FqPKHa-SX&xmsW4dv(Ii3x2sr2c)Du&4X5lwIGPgiVGG+rAJlY31&BfdtFQ+U#!C%$-di9yIQVSw&n3$Nb5&J6Zrm5EN-pbvPoh+8jUEJx4HxEg-RwsGF+Mk64e(tDs-X90QBd+Hukf&gcLY3H3Dch9!#mtHYzq0yp95dC(dCUKxj%I5en$s$3YYcgEggy**f2XGgN8ht$NsIc3%RZlT85ZIdGcAx8tdRWuX)t70ui2VHz*QkDz3cX(+4WkBGBqc0$%5w62n2dKuHa-4qWqyZjUuhcX95!Zpvp)#xbQkXpJj6r7A$iv8eMV#lBQLH$-ou*XV0SECQ0X$WeGK-8fxWc+Bg!Et4)aBxRUUziyUWMGnu8%vMOmjuDK*EOK(y&UhE*b88rta$am+WjPhPtknqZU%DT8HyvnqfxVo+Q$IYnnb%(z#bVSFdLv8Wxy5Z#cXG8bMH%CuCXhQhRcyICeCB6eVYcsn0zXwi6Z%r2EqY*#Ptw#ZZ#jU5wKc#J!WreZsU&0aAC*ml6+HKeU!Np(izjnKJS1-6PxoQjB#uC5M4LwH(RkHM%B06dJbC1uhyd0cV(H*41PvqReC#1A7Y7JvYCSf#X&-2a7Retm!4V3S!qbgB-Dd#A5BLIYrk$7V&0a+$yeuDNJoDcwjOHCO97U)+O4&8NfRqfgDlcI-$IvWIaIg)SzkVk*DeJ#akTIGxb4Jzs#eHXIUf3dPNpxj!PEgNiJ1yuQXXj5jDuSzG+M*!Pyg0ZY+r209q8q26zkqi1XeFDoj5N0y%Oo2CW)4u!LMXLTyr2DaQNjeZv$0K-z$OL#KIi!JaJ+YXFx8A!52S0bUf%J3E+NG$Md2o-vOyktL1Ceg)omZ!9g-uHFs6QazS$YE1mFittblN*(P13IdL&v(GBCDM9wAL+3uZOSQPEc#khAmhN#)US8Uw9nq6nmHo%)4hBcZD766dW8LfSn2Cu2mkWXpt9BJ*hMdRkMm66o$VrIpCnsaZDu42AB1g#g9qA0C%cub*a%KYG%HQtG8vHP-O8tLC-U11*xDmFYw0itxtMYXqmi2UgOb*LCI)YXtCchPDM3JqfouDT8X4+HJX-T-$-O8R1k8ARrGcjFjiQSo-lL4p1LEd4D&6(geODGScf0xTPOC7k78bU9mJp%g+aK2+QnWhL9OsktX&VgcH0Vi36lWsE+7ZQGi)xwsLU8ZDhPuk1JJl#hpkNMyWnvGLQyw3Uq3XowE6DrYa*mMOuDja9bdc4WqNQtPG-JpPS)u3KW)qaLdFFeICy)ookS6idu!UD)IEwevy-v22fnUk4C%%HNDc%T()0GXmtbYJIS-jDU&&QkDyvoQKoerJ)8oq1+ymxyM%6cK)*AU6gexQ54OG&V5OVhttcP#XnwE$-tnn0Qf3aHyXUqoLi7aoJ)b!OLXjEBqhH+z5$4R#GITSP%hT$RgoB4#CLqlkn%Yp7A+dW5AyEplXwG+!6ceig9$z#-SccOPc0jW7enxKJB0#%z9&alRV1RR0)cBWVBd*5J#hD5UWyNTuHqffkndlFtONnE9X4!pAs5F-l!D9FZCSdk*mJ)xbwW7uZUCcByM#X4rMPmf!freyIlTjDVKVhwmRTmul$U%gMfVq$mEJv*pHkxl-06zXWD7k1CxgUtzETr*9rszWYzf-S+r2Vd)oVMbiJqtUjHW)pc&D-d8QAOqEcURy1q&VRLAeIi5hPMw!dkDj9fDBtG8PCxX8!uZNi3kZUOvu%v(tS*&L5aW2SC(1Od$OQUXIOGi$O+$Z8oQBY2Wx4vC$F1jPACDS)OxF3MJs0(B6J5sCu3ohQQhov3*s7XoE1(9*EbTZ*U(Ocg+-V%F!JK%o(c59A2EYf)27CT#$$$)az3Z-3bX-ZZ0L!S0rJmPuiewBUxLNvV)3cokGBoRuembSyDtx115nk-yX4huZD7yH0z9X3P$qjdIpSwj*!a*OZf0lV%!#L3W-xEVJ&(X-BpB54CC7mdVdsx144vHD+jsIP6D9ozo2orR9*%lmjzs0kwh-lfGirolDX6kqj-tBkJA$RB)sAKd#yqVc*OGhB2%Fphyv!CkDz0%d&KCo25%-DE)URx-oHMxfZqUP&04TKwxIGDObWiHwAq#I8UI*Q5&4Erz7#TZ(qaTerkY0Q)MVbpkA-EgCJgS28ByYrJ5Hj9sHC8jii9)YoqnDmCg+cPFO3Ff&Lr0CFwHvH6VyNbkBwP%A+x4hDuVIh0i*by1HynYylEZgPrju$R0Q)Qmg0D$scge5GCyl6WY$X*LbB1dPnBYjYe&!pW%GO1!qBr+5UHwaoKsRHVbgI1ZZ0TMJdXdRePvc8Pq4IUfhJqrZtXauO2y4KHjG*x1x9&7EE74Ul)VB*PkpoAuMIX8jiBE4B+(nDFoW*M(PxWO1H35zJL-1AQeC+3k#wI$$AaoBOspHST+xg7GJcbFntPcxKRJ(b+yQRsUFAZl#FeQy8moaj8NdAv1kDlH(tdewH6B*qH*7tS41$LdlDgg2Y60VnD2TFNp$4LN1UIeCKHwh1XPQE8t6AoYx#G!-n9zR0ey$BfQ&QcbY$$HHJbBU-crO9SIRfvcvk9$TCo$Zuf5JAykb344&C2lDsG#2mL0c(#(k!MpHrW9uV-6yNypU(6r!3VDx2*(*XU)x8HU(b0F(7-BM3V5*6*r20M2i1PqK5uQu)3sXZUjzE-dvUEuuI2RUe3rhMS1!8nt!N-p9yZ0sV9yono%PHcLiI)6H-c8V95GJa55v(64Is(-+8&CeOPuK9ywD8&j+%!JOZbKqqPwHiud*#q&d*NYzd)0SMBHXblR$SiAE-d4WGyzRlD)vnOIsjyAVF!VVE(Z#b2s1i(lH*9s1eCD4FaLZ#Kndu7jCi7Nzs-T09KF1APlooBxGP1J(V0B8Uvv&D95P2(00CY6UDIHiTdX3btc%ilOU98Rz)MdDW2hA#q50iMP913339qeJpMfWcU$HF+wWWxEvHy7DX1bmzUkKTYph%qTJf1ukThJ)7X3m9qDJl-kbJTHfI!3bf3T6O*LbwnpwsCm9GxCcMt(8ZXsX%ESvE4%2uxS(tisNpR#MmjD6SScF#61*B8Wm*OMrSTqzol#6xTdDM0g+Y84wjH#cjMR5U!S-rZpMk2(50jcKVl8vq4hYbNwpQhGQLk&tZNkxcLurBT6uQ)rxTbixad*dwBQP)aTjPd)ULsYE#IZWutOevAwbkr3b3&PMjnA6XFI2gi8FZrbsp7HVK77IFzTQ5Gdt(JVwqFLU3NEDU6QO3GmnqrsxK-Bm6NZ$MyExTTyrG