邊緣性頜骨骨髓炎的表征
//hzlcwl.cn2009-06-09 21:49:33 來源:全民(min)健康網
急(ji)性(xing)(xing)(xing)期(qi)不(bu)易發現,常(chang)被(bei)頜周間(jian)隙感染癥(zheng)狀所掩蓋,因此(ci)常(chang)見(jian)為慢性(xing)(xing)(xing)期(qi)。臨(lin)床病理特點(dian)主要是間(jian)隙感染,如咬肌(ji)間(jian)隙和(he)翼(yi)下頜間(jian)隙膿(nong)(nong)腫(zhong),膿(nong)(nong)腫(zhong)未(wei)能及(ji)時(shi)(shi)(shi)排(pai)出,則會(hui)溶解(jie)骨(gu)(gu)膜(mo),使骨(gu)(gu)皮質的營養中斷,發生(sheng)(sheng)脫鈣、疏松(song)、軟化(hua),形成(cheng)(cheng)表淺的小(xiao)塊(kuai)(kuai)死(si)骨(gu)(gu);或(huo)因炎(yan)癥(zheng)與(yu)機體抵抗(kang)力(li)處(chu)于僵(jiang)持(chi)階段而出現炎(yan)性(xing)(xing)(xing)增生(sheng)(sheng),X線(xian)片可(ke)(ke)見(jian)頜骨(gu)(gu)表面(mian)蔥皮樣鈣化(hua)影。臨(lin)床可(ke)(ke)在(zai)下頜角(jiao)區域腮(sai)腺咬肌(ji)區出現炎(yan)潤硬塊(kuai)(kuai)、壓痛、凹陷性(xing)(xing)(xing)水(shui)腫(zhong),并有張口受限。膿(nong)(nong)腫(zhong)自行(xing)穿破處(chu)或(huo)切開引流區,可(ke)(ke)見(jian)長期(qi)溢膿(nong)(nong)的瘺管,有時(shi)(shi)(shi)膿(nong)(nong)液內(nei)(nei)混(hun)雜有死(si)骨(gu)(gu)碎(sui)屑。循(xun)瘺管探(tan)查(cha),可(ke)(ke)觸及(ji)粗澀骨(gu)(gu)面(mian),當瘺管阻塞時(shi)(shi)(shi),炎(yan)癥(zheng)又可(ke)(ke)急(ji)性(xing)(xing)(xing)發作。炎(yan)癥(zheng)發展深入到(dao)骨(gu)(gu)髓(sui)腔時(shi)(shi)(shi),感染可(ke)(ke)在(zai)骨(gu)(gu)髓(sui)腔內(nei)(nei)擴散,則可(ke)(ke)并發中央(yang)性(xing)(xing)(xing)骨(gu)(gu)髓(sui)炎(yan),而有大塊(kuai)(kuai)死(si)骨(gu)(gu)形成(cheng)(cheng)。
邊緣性骨(gu)髓炎(yan)多發生(sheng)在下頜骨(gu),多由(you)于下頜智齒冠周炎(yan)波(bo)及(ji)咬肌間隙而繼發。
急性期(qi)的(de)臨床特點(dian)與咬肌間隙、翼(yi)下頜間隙感染的(de)表現相似,局部紅腫熱痛,張口困難,可伴全身發熱。 相關藥(yao)品 抗生(sheng)素
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