口腔頜面部損傷2

口腔頜面部損傷Dr.SteveGFShenOralandMaxillofacialSurgerySchoolofStomatologyShanghaiNinthPeople’sHospitalShanghaiSecondMedicalUniversityOral&MaxillofacialTraumaChapter7Vocabularyabrasion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2024/9/92Vocabularycyanosis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2024/9/93Vocabularyhemostat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2024/9/94Vocabularyobstructiveasphyxia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營救，搶救2024/9/95Vocabularyrespiratory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2024/9/96Definitionoftraumatrauma

noun[CorU]severeemotionalshockandpaincausedbyanextremelyupsettingexperience:

thetraumaofmarriagebreakdown

Hehadpsychotherapytohelphimdealwithhischildhoodtraumas.SPECIALIZEDasevereinjury,usuallycausedbyaviolentattackoranaccident(fromCambridgeAdvancedLearner'sDictionary)2024/9/97Section1IntroductionWarIncidenceTrafficAccidentSportsFallingBustupLaborinjury2024/9/9824萬14.2萬人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)NooftrafficaccidentTrafficAccident2024/9/99TrafficAccident2024/9/910

Combinedinjurytootherviscera-Fataltolife

Damagetomaxillofacialstructure

Stomatognathicdysfunction

Facialestheticproblem

PsychologicaltraumaEffectofTraumaontheHumanBody2024/9/9111.RichbloodsupplySection2CharacteristicsofOMFTrauma2024/9/912DebridementTime:24–48hTendto hematoma,edemaRespiratorytractAsphyxiaAbilitytoanti-infection,regenerationWoundhealing1.Richbloodsupply2024/9/913

Cerebralconcussion

Cerebralcontusion

Intracranialhematoma

Skullbasefracture

Increaseinfectiousincidence

Malocclusioncaused-Diagnosis

Occlusionregained-Treatment2.Relationshipbtwtooth&OMFtrauma3.Cranio-cerebraltrauma2024/9/914Mouthopening,mastication,swallowing4.Cervicaltrauma5.Effectonbreathing6.EffectofondigastricsystemBleedingParalysis 癱瘓LeadingdifficultybreathingdietworseoralhygieneAsphyxia窒息2024/9/9157.Multi-sinus

-contamination

InfectionOralcavityNasalcavityPharyngealcavityOrbitParanasalsinusBacteriaTempHumidity2024/9/9168.DamagetospecificstructureParotidGlandFacialN.TrigeminalN.SalivaryfistulaFacialparalysisRegionalnumbness2024/9/9179.FacialDefect

FacialcontourPsychologicaltrauma2024/9/918EvaluatetraumasoonIdentifythekeytrauma,managethefatalfirstCarefulhistorytaking,thoroughphysicalexamRescueintimeManagementinorderGeneralRulesSection3Rescue2024/9/9191.PreventionofAsphyxiaSection3Rescue2024/9/920Dysphoria,sweating,inhalingrespirationDifficulttoinhale,hypopnea,nasalalarmovement,labialcyanosisThreeconcavesigns、Rapidbreathing,weakpulse,decreasedBPPupilsdiluted,Noreflectiontolight1.1ClinicalfeaturesofasphyxiaProdrome2024/9/9211.2

EtiologyofAsphyxia

ForeignbodyobstructionInspiratoryAsphyxiaLowAirwaySwellingForeignbodyBlood,salivaVomitUpperairwayTissuedislocation

ObstructiveAsphyxia2024/9/9221.3

RescueofAsphyxiaClearforeignbodyinupperairwaySuspendmaxillaIntubationHoldthetongueoutObstructiveAsphyxia吸入性窒息氣管切開術(shù)2024/9/923

2.HemostasiaTwosteps：JudgebleedingsituationChoosethewaytostopbleedingSection3Rescue2024/9/9242.1

JudgebleedingsituationThreecategoriesArterialCapillaryVenousBasedonorigin2024/9/925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2.2

Methodsofhemostat2024/9/9263.Anti-shocktreatment(2)

Purposeofanti-shock(1)

Definition&Classification

TraumaticshockExsanguineshock

>20%BodyweightToxicshockInfectiousshock

Restorecirculation2024/9/927(4)

PrinciplesofTreatment

(3)

FeaturesofShockEarlystage:Dysphoria,quick&superficialbreath,sweating,palenessMiddlestage:Tingletosupression,emotionalfaint,unconsciousness,decreaseBP,labialpalenessLatestage:weakerpulsation,unmeasurableBP,hyponuria,anuria<30ml/hHemostasis,bloodtransfusion,paincontrol,fluidtransfusion,sedation2024/9/928(1)

Judgement4.CombinedCraniocerebralInjuriesConsciousness,pulse,BP,respiration,pupil(2)Earlydiscovery,earlymanagementRetrogradeobliviscence CerebralconcussionIntermediatewake-up ExtraduralhematomaCerebralfluidleak Skullbasefracture2024/9/9292024/9/930DebridementWoundclosureAntibiotics5.PreventionofInfection6.Bandage&Transportation2024/9/931

Section4SoftTissueTrauma2024/9/932Abrasions 擦傷Contusions 挫傷Contusions&Lacerations 挫裂傷Incised&PunctureWound 切割傷及刺傷BiteWound

咬傷TypesofinjuriesSection4SoftTissueTrauma2024/9/933Character:Irregularwoundedge,foreignbody,pain,oozing&yellowishplasmaoozingManagement:Debridement,removeforeignbody,Drywound,drainwheninfected1.AbrasionsProperty:roughsurfaceEpidermis&superficialdermis2024/9/9341.Abrasions2024/9/9352.ContusionsCharater:petechia,swelling,painManagement:

HemostasisPain-killerPreventionofinfectionHematomaresorptionRe-establishmentoffunctionProperty:bluntmaterial&felltohardobjectSubdermaltissue(noopenwound)2024/9/936Property:Bluntobjectwithhighmechanicalforce3.Contusions&LacerationsCharacterIrregularwoundedge,saw-toothedBiglacerationw/wonecrotictissue&openfracturesManagementDebridementWoundClosureSofttissue2024/9/9373.Contusions&Lacerations2024/9/938Property:Sharpobjectorinstruments4.Incised&PunctureWoundCharater

RegularwoundedgeBleedingSmallaccess,butdeepwoundManagementDebridementWoundclosureSofttissue2024/9/939Property:Animal(Wolf,dog,Bear)orhumanbeingsCharacterToothtracedHeavycontaminationTendtoinfectionManagementThoroughdebridementInfectioncontrolSkingraftaftergranulartissueregeneratedVaccinationofTetanus,Rabies5.BiteWound2024/9/940DefinitionDebridement

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,orcontaminatedtissue2024/9/941Protocol1.washwound

Time：6--12h

Solution:soapwater,saline,hydrogendioxideDebridement3.Closure2.Cleanwound

Removalofforeignbody Trimmingofnecrotictissue2024/9/9422024/9/943CheekinjuriesPalateinjuriesInjuriesatotherregionsManagementofsofttissureinjuriesTongueinjuriesLengthmaintain,longitudinalclosureIndependentclosure,buttonguesuturedominationBigneedlewithbig,depthsuturingormatricsuturing2024/9/944Managementofsofttissureinjuries2024/9/9452024/9/946Section5InjuryofTeethandDentalAlveolarProcess2024/9/9471.Toothinjuries

1.1ContusionofTeethEtiology:Extrinsicforce blunttoothinjuries

PeriodontalligamentsordentalpulpCharacter:ExtrusionoftoothMobilityPercussion&ToothachewhenchewingManagementToothrestToothgroundSimpleligation2024/9/9481.Toothinjuries

1.2LuxationofTeethClassificationCharacterToothdislocatedorexfoliatedManagementToothprotectionpriorityReductionFixationReimplantationPartialluxationCompleteluxation-Toothdislocation-Semiluxation-Intrusivemovement2024/9/949Gingivalorlabialswelling,lacerationAdjacentteethoralveolarproce