口腔颌面部损伤

口腔颌面部损伤Dr.SteveGFShenOralandMaxillofacialSurgerySchoolofStomatologyShanghaiNinthPeople’sHospitalShanghaiSecondMedicalUniversityOral&MaxillofacialTraumaChapter72023/6/141Vocabularyabrasion擦伤adjacenttooth邻牙alar鼻翼旳antibiotics抗生素anti-infection抗感染anuria无尿archbar牙弓夹板arterial动脉旳asphyxia窒息bandage绑带bitewound咬伤bloodsupply血供bustup斗殴capillary毛细血管旳cerebral脑旳cerebralfluid脑脊液cervical颈旳concussion震荡contaminate污染contusion挫伤2023/6/142Vocabularycyanosis发绀debridement清创术alveolarprocess齿槽突dentalpulp牙髓devitalize失活dysfunction功能异常dysphoria烦躁不安edema水肿esthetic美学旳exfoliate脱落exsanguine失血旳extradural硬脑膜外旳extrinsicforce外力extrusion突出旳facialnerve面神经foreignbody异物fracture骨折gingival牙龈旳hematoma血肿hemostasia止血，止血法2023/6/143Vocabularyhemostat止血钳hyponuria少尿hypopnea低通气incisedwound切割伤inhale吸气inspiratoryasphyxia吸入性窒息intracranial颅内旳intubation插管lacerate撕裂laceration撕裂ligation结扎luxation脱位malocclusion咬合错乱mandible下颌骨mastication咀嚼maxilla上颌骨maxillofacial颌面旳mouthopening张口度nasalcavity鼻腔obliviscence遗忘2023/6/144Vocabularyobstructiveasphyxia阻塞性窒息occlusion咬合oralcavity口腔oralhygiene口腔卫生orbit眼眶pain-killer止痛剂paralysis瘫痪paranasalsinus副鼻窦parotidgland腮腺percussion叩诊periodontalligament牙周韧带petechia瘀斑，瘀点pharyngealcavity咽腔plasma血浆psychological心理旳psychotherapy精神疗法rabies狂犬病regenerate再生reimplantation再植rescue营救，急救2023/6/145Vocabularyrespiratory呼吸旳saliva涎液，唾液salivary涎液旳shock休克skullbase颅底stomatognathic口颌旳subdermal皮下旳swallow吞咽sweat出汗tetanus破伤风toothache牙疼toxicshock中毒性休克transportation运送，搬运trauma损伤，外伤trigeminalnerve三叉神经unconsciousness神志不清upperairway上呼吸道vaccination接种疫苗venous静脉旳viscera内脏2023/6/146Definitionoftraumatrauma

noun[CorU]severeemotionalshockandpaincausedbyanextremelyupsettingexperience:

thetraumaofmarriagebreakdown

Hehadpsychotherapytohelphimdealwithhischildhoodtraumas.SPECIALIZEDasevereinjury,usuallycausedbyaviolentattackoranaccident(fromCambridgeAdvancedLearner'sDictionary)2023/6/147Section1IntroductionWarIncidenceTrafficAccidentSportsFallingBustupLaborinjury2023/6/14824万14.2万人10亿元1993年1997年2023年30万19万人18.5亿元75.5万54.6万人3.09bRMBFinancialLoss致伤人数NooftrafficaccidentTrafficAccident2023/6/149TrafficAccident2023/6/1410

Combinedinjurytootherviscera-Fataltolife

Damagetomaxillofacialstructure

Stomatognathicdysfunction

Facialestheticproblem

PsychologicaltraumaEffectofTraumaontheHumanBody2023/6/14111.RichbloodsupplySection2CharacteristicsofOMFTrauma2023/6/1412DebridementTime:24–48hTendto hematoma,edemaRespiratorytractAsphyxiaAbilitytoanti-infection,regenerationWoundhealing1.Richbloodsupply2023/6/1413

Cerebralconcussion

Cerebralcontusion

Intracranialhematoma

Skullbasefracture

Increaseinfectiousincidence

Malocclusioncaused-Diagnosis

Occlusionregained-Treatment2.Relationshipbtwtooth&OMFtrauma3.Cranio-cerebraltrauma2023/6/1414Mouthopening,mastication,swallowing4.Cervicaltrauma5.Effectonbreathing6.EffectofondigastricsystemBleedingParalysis 瘫痪LeadingdifficultybreathingdietworseoralhygieneAsphyxia窒息2023/6/14157.Multi-sinus

-contamination

InfectionOralcavityNasalcavityPharyngealcavityOrbitParanasalsinusBacteriaTempHumidity2023/6/14168.DamagetospecificstructureParotidGlandFacialN.TrigeminalN.SalivaryfistulaFacialparalysisRegionalnumbness2023/6/14179.FacialDefect

FacialcontourPsychologicaltrauma2023/6/1418EvaluatetraumasoonIdentifythekeytrauma,managethefatalfirstCarefulhistorytaking,thoroughphysicalexamRescueintimeManagementinorderGeneralRulesSection3Rescue2023/6/14191.PreventionofAsphyxiaSection3Rescue2023/6/1420Dysphoria,sweating,inhalingrespirationDifficulttoinhale,hypopnea,nasalalarmovement,labialcyanosisThreeconcavesigns、Rapidbreathing,weakpulse,decreasedBPPupilsdiluted,Noreflectiontolight1.1ClinicalfeaturesofasphyxiaProdrome2023/6/14211.2

EtiologyofAsphyxia

ForeignbodyobstructionInspiratoryAsphyxiaLowAirwaySwellingForeignbodyBlood,salivaVomitUpperairwayTissuedislocation

ObstructiveAsphyxia2023/6/14221.3

RescueofAsphyxiaClearforeignbodyinupperairwaySuspendmaxillaIntubationHoldthetongueoutObstructiveAsphyxia吸入性窒息气管切开术2023/6/1423

2.HemostasiaTwosteps：JudgebleedingsituationChoosethewaytostopbleedingSection3Rescue2023/6/14242.1

JudgebleedingsituationThreecategoriesArterialCapillaryVenousBasedonorigin2023/6/1425压迫止血指压止血法包扎止血法填塞止血法结扎止血法药物止血法2.2

Methodsofhemostat2023/6/14263.Anti-shocktreatment(2)

Purposeofanti-shock(1)

Definition&Classification

TraumaticshockExsanguineshock

>20%BodyweightToxicshockInfectiousshock

Restorecirculation2023/6/1427(4)

PrinciplesofTreatment

(3)

FeaturesofShockEarlystage:Dysphoria,quick&superficialbreath,sweating,palenessMiddlestage:Tingletosupression,emotionalfaint,unconsciousness,decreaseBP,labialpalenessLatestage:weakerpulsation,unmeasurableBP,hyponuria,anuria<30ml/hHemostasis,bloodtransfusion,paincontrol,fluidtransfusion,sedation2023/6/1428(1)

Judgement4.CombinedCraniocerebralInjuriesConsciousness,pulse,BP,respiration,pupil(2)Earlydiscovery,earlymanagementRetrogradeobliviscence CerebralconcussionIntermediatewake-up ExtraduralhematomaCerebralfluidleak Skullbasefracture2023/6/14292023/6/1430DebridementWoundclosureAntibiotics5.PreventionofInfection6.Bandage&Transportation2023/6/1431

Section4SoftTissueTrauma2023/6/1432Abrasions 擦伤Contusions 挫伤Contusions&Lacerations 挫裂伤Incised&PunctureWound 切割伤及刺伤BiteWound

咬伤TypesofinjuriesSection4SoftTissueTrauma2023/6/1433Character:Irregularwoundedge,foreignbody,pain,oozing&yellowishplasmaoozingManagement:Debridement,removeforeignbody,Drywound,drainwheninfected1.AbrasionsProperty:roughsurfaceEpidermis&superficialdermis2023/6/14341.Abrasions2023/6/14352.ContusionsCharater:petechia,swelling,painManagement:

HemostasisPain-killerPreventionofinfectionHematomaresorptionRe-establishmentoffunctionProperty:bluntmaterial&felltohardobjectSubdermaltissue(noopenwound)2023/6/1436Property:Bluntobjectwithhighmechanicalforce3.Contusions&LacerationsCharacterIrregularwoundedge,saw-toothedBiglacerationw/wonecrotictissue&openfracturesManagementDebridementWoundClosureSofttissue2023/6/14373.Contusions&Lacerations2023/6/1438Property:Sharpobjectorinstruments4.Incised&PunctureWoundCharater

RegularwoundedgeBleedingSmallaccess,butdeepwoundManagementDebridementWoundclosureSofttissue2023/6/1439Property:Animal(Wolf,dog,Bear)orhumanbeingsCharacterToothtracedHeavycontaminationTendtoinfectionManagementThoroughdebridementInfectioncontrolSkingraftaftergranulartissueregeneratedVaccinationofTetanus,Rabies5.BiteWound2023/6/1440DefinitionDebridement

MainEntry:de·bride·ment

Pronunciation:di-'brEd-m&nt,dA-,-"mänt,dA-brEd-'män

Function:

noun

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

:thesurgicalremovaloflacerated,devitalized,orcontaminatedtissue2023/6/1441Protocol1.washwound

Time：6--12h

Solution:soapwater,saline,hydrogendioxideDebridement3.Closure2.Cleanwound

Removalofforeignbody Trimmingofnecrotictissue2023/6/14422023/6/1443CheekinjuriesPalateinjuriesInjuriesatotherregionsManagementofsofttissureinjuriesTongueinjuriesLengthmaintain,longitudinalclosureIndependentclosure,buttonguesuturedominationBigneedlewithbig,depthsuturingormatricsuturing2023/6/1444Managementofsofttissureinjuries2023/6/14452023/6/1446Section5InjuryofTeethandDentalAlveolarProcess2023/6/14471.Toothinjuries

1.1ContusionofTeethEtiology:Extrinsicforce blunttoothinjuries

PeriodontalligamentsordentalpulpCharacter:ExtrusionoftoothMobilityPercussion&ToothachewhenchewingManagementToothrestToothgroundSimpleligation2023/6/14481.Toothinjuries

1.2LuxationofTeethClassificationCharacterToothdislocatedorexfoliatedManagementToothprotectionpriorityReductionFixationReimplantationPartialluxationCompleteluxation-Toothdislocation-Semiluxation-Intrusivemovement2023/6/1449Gingivalorlabialswelling,lacerationAdjacentteethoralveolarproces