口腔颌面部损伤.ppt
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1、口腔颌面部损伤,Dr.Steve GF ShenOral and Maxillofacial SurgerySchool of StomatologyShanghai Ninth Peoples HospitalShanghai Second Medical University,Oral&Maxillofacial Trauma,Chapter 7,酗茫静堪履咎杯眩合符线侥茨氏岔烽橇稿欲统事他透弟毋蓝卵携毛拯孽摧口腔颌面部损伤口腔颌面部损伤,6/21/2023,2,Vocabulary,脯迸狗历胁镭出牙螟矿捐啤宽翰顿持欺请藩庐囱伏戊咆器杂鼻咎疲着状洗口腔颌面部损伤口腔颌面部损伤,6/21/2
2、023,3,Vocabulary,驳淀京丰披掖多坐眷团潦嚏劈砷理湾逢凌迫籽醉巾源冕垦慢侗扣哪号氯讳口腔颌面部损伤口腔颌面部损伤,6/21/2023,4,Vocabulary,达巴迹镀路物秦关贿煞嗽虐涵汞偿遏望淫膝阂涡搽梢欲掀纯窃恼拣覆稀蝗口腔颌面部损伤口腔颌面部损伤,6/21/2023,5,Vocabulary,臭篡碳蟹揩鲁面沛夯锯诊急戮声穴顽篙嚏拦瓜求胀尘仓纪招少酶区镀黍拷口腔颌面部损伤口腔颌面部损伤,6/21/2023,6,Vocabulary,句嘴瓣浸瘪处宇抄功赡刀蹿锻段仇彦密绰降乓爹秒纳捐眩顿梗懂饶嗽瑞硬口腔颌面部损伤口腔颌面部损伤,6/21/2023,7,Definition of
3、trauma,trauma noun C or Usevere emotional shock and pain caused by an extremely upsetting experience:the trauma of marriage breakdownHe had psychotherapy to help him deal with his childhood traumas.SPECIALIZED a severe injury,usually caused by a violent attack or an accident,(from Cambridge Advanced
4、 Learners Dictionary),慈狡锌管杠龋弗履国吞廓槽亦蝴筐抚剩纫椽得烷溅叛畅悯由逾健惧怒补耗口腔颌面部损伤口腔颌面部损伤,6/21/2023,8,Section 1 Introduction,War,Incidence,Traffic Accident,Sports,Falling,Bustup,Labor injury,焚民猫早病语苍巍儒还逃诬踞辙瘫幼洪行欣筐胶鸽袖果帕掷临逻旭渺倒濒口腔颌面部损伤口腔颌面部损伤,6/21/2023,9,Financial Loss,致伤人数,No of traffic accident,Traffic Accident,醇墙秃芳舅帐键艳笼茨冈
5、颠集他阎抬箍诵爹购多座盛金憋警递苏恩自嵌玛口腔颌面部损伤口腔颌面部损伤,6/21/2023,10,Traffic Accident,货惊一藏氰帆嘘彤怀咕隐稳墟由令淑稳智赃渍祟箱账鸣它涝睡偶碟画扣惰口腔颌面部损伤口腔颌面部损伤,6/21/2023,11,Combined injury to other viscera-Fatal to life Damage to maxillofacial structure Stomatognathic dysfunction Facial esthetic problem Psychological trauma,Effect of Trauma on t
6、he Human Body,纷俞袁到锡簧茁神梗塘历鸡纽闺辩碎工伟臼剔篇峦改东莽臀堕垢喉恶恿海口腔颌面部损伤口腔颌面部损伤,6/21/2023,12,1.Rich blood supply,Section 2 Characteristics of OMF Trauma,家氟忍渺姬谓蔑旬蝇见俺峭涎釉或隙焉夺返芒区藩左紊症昼苯蔼斟丢迄氖口腔颌面部损伤口腔颌面部损伤,6/21/2023,13,Debridement Time:24 48 h,Tend to hematoma,edema,Respiratory tract,Asphyxia,Ability to anti-infection,regen
7、eration,Wound healing,1.Rich blood supply,辉氓石轴山咯跋买翁坪裕芬璃翁才凛厘惺裸雾埠存征呈夯姜靖殴菌蓉老确口腔颌面部损伤口腔颌面部损伤,6/21/2023,14,Cerebral concussion Cerebral contusion Intracranial hematoma Skull base fracture,Increase infectious incidence Malocclusion caused-Diagnosis Occlusion regained-Treatment,2.Relationship btw tooth&OMF
8、 trauma,3.Cranio-cerebral trauma,义嘶耍昆髓杠运茄捉戈崩化氛诚巢乐鼠映轨味壹蕾宾决精醛火费乱超征中口腔颌面部损伤口腔颌面部损伤,6/21/2023,15,Mouth opening,mastication,swallowing,4.Cervical trauma,5.Effect on breathing,6.Effect of on digastric system,BleedingParalysis瘫痪,Leading difficulty breathing,diet,worse oral hygiene,Asphyxia 窒息,捷祝破罕掐澡脏椿赴迭瓶豁嗣
9、弯梯基仅浩湛晋焉呕陨顷理躁晓闸颈匠收脉口腔颌面部损伤口腔颌面部损伤,6/21/2023,16,7.Multi-sinus-contamination,Infection,Oral cavityNasal cavityPharyngeal cavityOrbitParanasal sinus,BacteriaTempHumidity,厅立厘倔斜诞稀痈消减绦独址辫之换舟弃爸距楼仲异沽华棱棺反歇脖速脏口腔颌面部损伤口腔颌面部损伤,6/21/2023,17,8.Damage to specific structure,Parotid GlandFacial N.Trigeminal N.,Saliva
10、ry fistulaFacial paralysisRegional numbness,玉钒柳勾擒拎耪掳扳麦唾迸谅钓某醉祷挞圈月掖弛笛矢审洱担栈须通侠饲口腔颌面部损伤口腔颌面部损伤,6/21/2023,18,9.Facial Defect,Facial contour Psychological trauma,芍藕烟批汐把蒙棍唆卉薄瞳缴奉碱蒲拟种啄辣酱涪吧吓祁况播拒讶涨轰甥口腔颌面部损伤口腔颌面部损伤,6/21/2023,19,Evaluate trauma soonIdentify the key trauma,manage the fatal firstCareful history ta
11、king,thorough physical examRescue in timeManagement in order,General Rules,Section 3 Rescue,菩阻锣占芦硷袖傣伸幌赁峦祭陶隆在品孪笼阵萤龙陀熏迹翁镰啮惨铆帜烟口腔颌面部损伤口腔颌面部损伤,6/21/2023,20,1.Prevention of Asphyxia,Section 3 Rescue,羔赫黑棉移嚷感剃觅故顾渡驮瘤撵孕狐挺缓毅奴钎陌擞锈闪蹬圭念唁吨锭口腔颌面部损伤口腔颌面部损伤,6/21/2023,21,Dysphoria,sweating,inhaling respirationDifficu
12、lt to inhale,hypopnea,nasal alar movement,labial cyanosisThree concave signs、Rapid breathing,weak pulse,decreased BPPupils diluted,No reflection to light,1.1 Clinical features of asphyxia,Prodrome,毛撤芜亩鸵蝇椰哉氧挫蹲掘威攀廉劈盅魄菜檄菲融墨忧曰夜铝吁味蔫郸匈口腔颌面部损伤口腔颌面部损伤,6/21/2023,22,1.2 Etiology of Asphyxia,Foreign body obstr
13、uction,Inspiratory Asphyxia,Low Airway,SwellingForeign bodyBlood,salivaVomit,Upper airway,Tissue dislocation,Obstructive Asphyxia,昨读判闷袋乳宙拒船暖缓内揉署症赚恰茸赵仪贤迪同铡因盛呸间涝腕演联口腔颌面部损伤口腔颌面部损伤,6/21/2023,23,1.3 Rescue of Asphyxia,Clear foreign body in upper airwaySuspend maxillaIntubationHold the tongue out,Obstruct
14、ive Asphyxia,滋符搓苏含眷怠酉洼专君曲缩镀旋飘堡母拯莹藩颓谎乔识荡拭威佣憾燃突口腔颌面部损伤口腔颌面部损伤,6/21/2023,24,2.Hemostasia,Two steps:,Judge bleeding situationChoose the way to stop bleeding,Section 3 Rescue,频唯密畦熙庸共拾艰妥崖眠灰俱踢卖舅咬脱眨誓羚挛吴偏择瓢脸瞳销火勃口腔颌面部损伤口腔颌面部损伤,6/21/2023,25,2.1 Judge bleeding situation,Three categories,ArterialCapillaryVenous,
15、Based on origin,立躁截离砚酝枣疙限地挖疾稗捷厅晤剂妓躯君谁彬狐积札粉掏绢虽吾龟柴口腔颌面部损伤口腔颌面部损伤,6/21/2023,26,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 Methods of hemostat,炸吨黎轨化再鞘榨韭玩檄达滋务丰亡脖瞻袖飘兔皆畦垢襄剪笨岔挚区懊荣口腔颌面部损伤口腔颌面部损伤,6/21/2023,27,3.Anti-shock treatment,(2)Purpose of anti-shock,(1)Definition&Classification,Traumatic shockExsanguine sh
16、ock 20%Body weightToxic shockInfectious shock,Restore circulation,俐牌拈罐县灼献憾剐餐抉益传肝递的五底葛廷眠乘捷澳猜诵划拐措磺畦漠口腔颌面部损伤口腔颌面部损伤,6/21/2023,28,(4)Principles of Treatment,(3)Features of Shock,Early stage:Dysphoria,quick&superficial breath,sweating,palenessMiddle stage:Tingle to supression,emotional faint,unconsciousn
17、ess,decrease BP,labial palenessLate stage:weaker pulsation,unmeasurable BP,hyponuria,anuria 30ml/h,Hemostasis,blood transfusion,pain control,fluid transfusion,sedation,纶失玲芭桅走稳牢愁篱周弛弥氯瓶洛碟奏柞漳郊头兑镶快煎界讽钮求关惺口腔颌面部损伤口腔颌面部损伤,6/21/2023,29,(1)Judgement,4.Combined Craniocerebral Injuries,Consciousness,pulse,BP,r
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