口腔頜面部損傷

1、口腔頜面部損傷口腔頜面部損傷oral & maxillofacial traumachapter 710/23/20212vocabulary10/23/20213vocabulary10/23/20214vocabulary10/23/20215vocabularyperiodontal ligamentpetechiapharyngeal cavityplasmapsychologicalpsychotherapyrabiesregeneratereimplantationrescue牙周韌帶瘀斑，瘀點(diǎn)咽腔血漿心理的精神療法狂犬病再生再植營(yíng)救，搶救10/23/20216vocabulary

2、venous10/23/20217definition of trauma(from cambridge advanced learners dictionary)10/23/20218section 1 introductionincidencetraffic accidentsportsfallingbustuplabor injury10/23/2021924萬(wàn)萬(wàn)14.2萬(wàn)人萬(wàn)人10億元億元1993年年1997年年2001年年30萬(wàn)萬(wàn)19萬(wàn)人萬(wàn)人18.5億元億元75.5萬(wàn)萬(wàn)54.6萬(wàn)人萬(wàn)人3.09b rmbfinancial financial lossloss致傷人數(shù)致傷人數(shù)no of

3、 traffic no of traffic accidentaccidenttraffic accident10/23/202110traffic accident10/23/202111effect of trauma on the human body10/23/202112section 2 characteristics of omf trauma10/23/202113debridement time: 24 48 htend to hematoma, edemarespiratory tractasphyxiaability to anti-infection, regenera

4、tionwound healing10/23/202114 cerebral concussion cerebral contusion intracranial hematoma skull base fracture increase infectious incidence malocclusion caused - diagnosis occlusion regained - treatment10/23/202115mouth opening, mastication, swallowingbleedingparalysis癱瘓leading difficulty breathing

5、dietworse oral hygieneasphyxia 窒息10/23/202116 infectionoral cavitynasal cavitypharyngeal cavityorbitparanasal sinusbacteriatemphumidity10/23/202117parotid glandfacial n. trigeminal n.salivary fistulafacial paralysisregional numbness10/23/202118 facial contour psychological trauma10/23/202119evaluate

6、 trauma soonidentify the key trauma, manage the fatal firstcareful history taking, thorough physical examrescue in timemanagement in ordergeneral rulessection 3 rescue10/23/202120section 3 rescue10/23/202121dysphoria, sweating, inhaling respirationdifficult to inhale, hypopnea, nasal alar movement,

7、labial cyanosisthree concave signs、rapid breathing, weak pulse, decreased bppupils diluted, no reflection to lightprodrome10/23/202122 foreign body obstructioninspiratory asphyxialow airwayswellingforeign bodyblood, salivavomitupper airwaytissue dislocation obstructive asphyxia10/23/202123clear fore

8、ign body in upper airwaysuspend maxillaintubationhold the tongue outobstructive asphyxia 吸入性窒息吸入性窒息氣管切開(kāi)術(shù)氣管切開(kāi)術(shù)10/23/202124two steps：judge bleeding situationchoose the way to stop bleedingsection 3 rescue10/23/202125three categoriesarterialcapillaryvenousbased on origin10/23/202126壓迫止血壓迫止血指壓止血法指壓止血法包扎

9、止血法包扎止血法填塞止血法填塞止血法結(jié)扎止血法結(jié)扎止血法藥物止血法藥物止血法10/23/202127(2) purpose of anti-shock(1) definition & classification traumatic shockexsanguine shock 20% body weighttoxic shockinfectious shock restore circulation10/23/202128(4) principles of treatment (3) features of shockearly stage: dysphoria, quick & superf

10、icial breath, sweating, palenessmiddle stage: tingle to supression, emotional faint, unconsciousness, decrease bp, labial palenesslate stage: weaker pulsation, unmeasurable bp, hyponuria, anuria 30ml/hhemostasis, blood transfusion, pain control, fluid transfusion, sedation10/23/202129(1) judgementco

11、nsciousness, pulse, bp, respiration, pupil(2) early discovery, early managementretrograde obliviscencecerebral concussionintermediate wake-upextradural hematomacerebral fluid leakskull base fracture10/23/20213010/23/202131debridementwound closureantibiotics10/23/202132section 4 soft tissue trauma10/

12、23/202133abrasions 擦傷contusions挫傷contusions & lacerations挫裂傷incised & puncture wound切割傷及刺傷 bite wound 咬傷 types of injuriessection 4 soft tissue trauma10/23/2021341. abrasions10/23/2021351. abrasions10/23/2021362. contusions10/23/202137property: blunt object with high mechanical force3. contusions &

13、lacerationscharacterlirregular wound edge, saw-toothedlbig lacerationlw/wo necrotic tissue & open fracturesmanagementl debridementl wound closure10/23/2021383. contusions & lacerations10/23/202139property: sharp object or instruments4. incised & puncture woundcharater l regular wound edgel bleedingl

14、 small access, but deep woundmanagementl debridementl wound closure10/23/202140property: animal (wolf, dog, bear) or human beingscharacterl tooth tracedl heavy contaminationl tend to infectionmanagementl thorough debridementl infection controll skin graft after granular tissue regeneratedl vaccinati

15、on of tetanus, rabies5. bite wound10/23/202141debridement10/23/2021421. wash wound time：6-12h solution: soap water, saline, hydrogen dioxidedebridement3. closure2. clean wound removal of foreign body trimming of necrotic tissue10/23/20214310/23/202144management of soft tissure injuries10/23/202145ma

16、nagement of soft tissure injuries10/23/20214610/23/202147section 5 injury of teeth and dental alveolar process10/23/2021481. tooth injuries 1.1 contusion of teethetiology: extrinsic force blunt tooth injuriesperiodontal ligaments or dental pulpcharacter: l extrusion of toothl mobilityl percussion &

17、toothache when chewingmanagementl tooth restl tooth groundl simple ligation10/23/2021491. tooth injuries 1.2 luxation of teethclassificationcharacterl tooth dislocated or exfoliatedmanagementl tooth protection priorityl reductionl fixationl reimplantationpartial luxationcomplete luxation- tooth disl

18、ocation- semi luxation- intrusive movement10/23/202150gingival or labial swelling, lacerationadjacent teeth or alveolar process movement when one affected tooth touchedfragment dislocation, malocclusionin accordance with tooth luxation or fracture2. fracture of alveolar processcharacters10/23/202151l extrinsic force to dental alveolar process, mainly to upper jawl reduction under lal arch bar applied2. fracture of alveolar processetiologymanagement 10/23/2021522. fracture of alveolar process10