口腔頜面部損傷課件

匯報人：xxx20xx-03-16口腔頜面部損傷ppt課件目錄口腔頜面部損傷概述阻塞性窒息與吸入性窒息牙齒損傷與周圍zu織影響頜骨骨折及其并發(fā)癥處理診斷方法與治療原則探討康復期管理與生活調(diào)整建議01口腔頜面部損傷概述口腔頜面部損傷是指頜骨、面部軟zu織、牙齒、顳下頜關(guān)節(jié)、涎腺及其導管等zu織器官在不同情況下受到外來力量作用而發(fā)生的各種損傷。定義根據(jù)損傷部位可分為軟zu織傷、牙及牙槽骨損傷、頜骨骨折、顳下頜關(guān)節(jié)損傷、涎腺及導管損傷等；根據(jù)致傷原因可分為擦傷、挫傷、刺傷、撕裂傷、砍傷、爆炸傷等。分類定義與分類交通事故、工傷事故、暴力犯罪、運動意外、生活意外（如跌倒、撞擊）等均可導致口腔頜面部損傷。發(fā)病原因年齡（兒童和老年人更易受傷）、性別（男性多于女性）、職業(yè)（從事高風險職業(yè)者）、酗酒、吸毒、精神疾病等。危險因素發(fā)病原因及危險因素以下附贈各項管理制度英文版（不需要可刪）急救藥品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.護理文書書寫制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.臨床表現(xiàn)疼痛、腫脹、出血、瘀斑、牙齒松動或脫落、咬合關(guān)系錯亂、張口受限、感覺異常、骨折段移位等。診斷依據(jù)詳細詢問病史，了解致傷原因、時間、部位及傷后表現(xiàn)；全面檢查傷者的口腔頜面部情況，注意有無合并其他部位損傷；拍攝X線片或CT等影像學檢查，明確骨折部位、類型及移位情況；根據(jù)臨床表現(xiàn)和影像學檢查結(jié)果，綜合分析判斷，作出正確診斷。臨床表現(xiàn)與診斷依據(jù)02阻塞性窒息與吸入性窒息血凝塊、骨碎片、牙碎片等異物移位至咽喉部，導致呼吸道阻塞。異物阻塞zu織移位喉頭水腫口底、舌根或頸部等zu織在損傷后發(fā)生腫脹、血腫或移位，壓迫呼吸道。損傷或感染導致喉頭水腫，引起呼吸道狹窄或阻塞。030201阻塞性窒息發(fā)病機制意識障礙或醉酒狀態(tài)下，將血液、唾液、嘔吐物等誤吸入呼吸道。誤吸火災現(xiàn)場吸入大量煙霧，其中包含的有害物質(zhì)損傷呼吸道黏膜，導致窒息?；馂臒熿F吸入有毒化學物質(zhì)，如氯氣、氨氣等，引起呼吸道損傷和窒息。化學物質(zhì)吸入性窒息發(fā)病機制阻塞性窒息表現(xiàn)為呼吸困難、鼻翼扇動、三凹征等；吸入性窒息則表現(xiàn)為嗆咳、呼吸急促、發(fā)紺等。兩者均可出現(xiàn)生命危險。通過詳細詢問病史、體格檢查和影像學檢查等手段，鑒別阻塞性窒息和吸入性窒息。同時，還需與喉痙攣、支氣管哮喘等疾病進行鑒別。臨床表現(xiàn)與鑒別診斷鑒別診斷臨床表現(xiàn)03牙齒損傷與周圍zu織影響牙震蕩01輕度松動者可不作特殊處理，避免咬硬物；重度松動者需對患牙進行固定。牙脫位02部分脫位應局麻下復位，并結(jié)扎固定4周；嵌入性脫位在復位后2周應作根管治療術(shù)；完全脫位牙在半小時內(nèi)進行再植，防止日后牙根吸收。牙折03缺損少，牙本質(zhì)未暴露的冠折，可將銳緣磨光；牙本質(zhì)已暴露，并有輕度敏感者，可行脫敏治療；敏感較重者，用臨時塑料冠；冠折露髓者，應盡早進行牙髓或根管治療。牙齒損傷類型及處理方法折斷牙碎片對周圍組織影響牙碎片飛散折斷的牙碎片可向鄰近zu織內(nèi)飛散，增加zu織的損傷。帶入細菌牙碎片可將牙石和細菌等帶入深層zu織，引起創(chuàng)口感染。影響骨折愈合頜骨骨折線上的牙偶爾導致骨創(chuàng)感染，影響骨折的愈合。預防措施避免咬硬物，注意運動安全，防止暴力撞擊；定期進行口腔檢查，及時發(fā)現(xiàn)并處理牙齒問題?？谇槐＝〗ㄗh養(yǎng)成良好的口腔衛(wèi)生習慣，早晚刷牙，飯后漱口；使用含氟牙膏預防齲齒；定期潔牙，去除牙菌斑和牙結(jié)石；多吃富含纖維的食物，鍛煉咀嚼能力。預防措施與口腔保健建議04頜骨骨折及其并發(fā)癥處理頜骨骨折類型及臨床表現(xiàn)出現(xiàn)面部塌陷、張口受限、咬合關(guān)系錯亂、復視及顱腦損傷等癥狀。出現(xiàn)張口受限、咬合關(guān)系錯亂、面部畸形、出血及神經(jīng)損傷等癥狀。骨折處軟zu織損傷嚴重，伴有出血和感染風險。骨折處皮膚或粘膜完整，無明顯開放傷口。上頜骨骨折下頜骨骨折開放性骨折閉合性骨折保留牙齒拔除牙齒牙齒固定后期修復骨折線上牙齒處理原則01020304對于無明顯松動、牙冠無折斷或折斷面位于牙齦以上的牙齒，應盡量保留。對于明顯松動、牙冠折斷嚴重或折斷面位于牙齦以下的牙齒，應予以拔除。對于需要保留的牙齒，可采用牙弓夾板、鋼絲結(jié)扎或正畸托槽等方法進行固定。對于拔除的牙齒，可在骨折愈合后進行義齒修復。術(shù)前徹底清創(chuàng)，去除壞死zu織和異物；術(shù)后保持傷口清潔，定期更換敷料；使用抗生素預防感染。預防感染一旦出現(xiàn)感染癥狀，應立即進行傷口引流、清洗和換藥；根據(jù)細菌培養(yǎng)和藥敏試驗結(jié)果選用敏感抗生素。早期治療對于已形成膿腫的傷口，應及時切開引流；對于死骨形成或骨髓炎等嚴重感染，應進行手術(shù)治療。ju部處理加強患者營養(yǎng)支持，提高機體抵抗力；對于嚴重感染者，可給予輸血、白蛋白等支持治療。全身支持治療骨創(chuàng)感染預防和治療策略05診斷方法與治療原則探討觀察患者面部是否有腫脹、畸形、創(chuàng)口等異常情況。望診檢查患者是否有壓痛、骨折斷端移位等體征。觸診觀察牙齒是否松動、移位、咬合關(guān)系是否正常。牙齒檢查常規(guī)檢查方法介紹CT檢查提供更詳細的頜面部三維結(jié)構(gòu)信息，有助于準確判斷骨折位置和程度。X線檢查用于檢查頜骨骨折、牙齒損傷等情況，可明確骨折類型、