上交大口腔颌面外科学课件08口腔颌面部损伤

口腔颌面部损伤Dr.SteveGFShenOralandMaxillofacialSurgerySchoolofStomatologyShanghaiNinthPeople’sHospitalShanghaiSecondMedicalUniversityOral&MaxillofacialTraumaChapter72026/2/102Vocabularyabrasion擦伤adjacenttooth邻牙alar鼻翼的antibiotics抗生素anti-infection抗感染anuria无尿archbar牙弓夹板arterial动脉的asphyxia窒息bandage绑带bitewound咬伤bloodsupply血供bustup斗殴capillary毛细血管的cerebral脑的cerebralfluid脑脊液cervical颈的concussion震荡contaminate污染contusion挫伤2026/2/103Vocabularycyanosis发绀debridement清创术alveolarprocess齿槽突dentalpulp牙髓devitalize失活dysfunction功能异常dysphoria烦躁不安edema水肿esthetic美学的exfoliate脱落exsanguine失血的extradural硬脑膜外的extrinsicforce外力extrusion突出的facialnerve面神经foreignbody异物fracture骨折gingival牙龈的hematoma血肿hemostasia止血，止血法2026/2/104Vocabularyhemostat止血钳hyponuria少尿hypopnea低通气incisedwound切割伤inhale吸气inspiratoryasphyxia吸入性窒息intracranial颅内的intubation插管lacerate撕裂laceration撕裂ligation结扎luxation脱位malocclusion咬合错乱mandible下颌骨mastication咀嚼maxilla上颌骨maxillofacial颌面的mouthopening张口度nasalcavity鼻腔obliviscence遗忘2026/2/105Vocabularyobstructiveasphyxia阻塞性窒息occlusion咬合oralcavity口腔oralhygiene口腔卫生orbit眼眶pain-killer止痛剂paralysis瘫痪paranasalsinus副鼻窦parotidgland腮腺percussion叩诊periodontalligament牙周韧带petechia瘀斑，瘀点pharyngealcavity咽腔plasma血浆psychological心理的psychotherapy精神疗法rabies狂犬病regenerate再生reimplantation再植rescue营救，抢救2026/2/106Vocabularyrespiratory呼吸的saliva涎液，唾液salivary涎液的shock休克skullbase颅底stomatognathic口颌的subdermal皮下的swallow吞咽sweat出汗tetanus破伤风toothache牙疼toxicshock中毒性休克transportation运输，搬运trauma损伤，外伤trigeminalnerve三叉神经unconsciousness神志不清upperairway上呼吸道vaccination接种疫苗venous静脉的viscera内脏2026/2/107Definitionoftraumatrauma

noun[CorU]severeemotionalshockandpaincausedbyanextremelyupsettingexperience:

thetraumaofmarriagebreakdown

Hehadpsychotherapytohelphimdealwithhischildhoodtraumas.SPECIALIZEDasevereinjury,usuallycausedbyaviolentattackoranaccident(fromCambridgeAdvancedLearner'sDictionary)2026/2/108Section1IntroductionWarIncidenceTrafficAccidentSportsFallingBustupLaborinjury2026/2/10924万14.2万人10亿元1993年1997年2001年30万19万人18.5亿元75.5万54.6万人3.09bRMBFinancialLoss致伤人数NooftrafficaccidentTrafficAccident2026/2/1010TrafficAccident2026/2/1011

Combinedinjurytootherviscera-Fataltolife

Damagetomaxillofacialstructure

Stomatognathicdysfunction

Facialestheticproblem

PsychologicaltraumaEffectofTraumaontheHumanBody2026/2/10121.RichbloodsupplySection2CharacteristicsofOMFTrauma2026/2/1013DebridementTime:24–48hTendto hematoma,edemaRespiratorytractAsphyxiaAbilitytoanti-infection,regenerationWoundhealing1.Richbloodsupply2026/2/1014

Cerebralconcussion

Cerebralcontusion

Intracranialhematoma

Skullbasefracture

Increaseinfectiousincidence

Malocclusioncaused-Diagnosis

Occlusionregained-Treatment2.Relationshipbtwtooth&OMFtrauma3.Cranio-cerebraltrauma2026/2/1015Mouthopening,mastication,swallowing4.Cervicaltrauma5.Effectonbreathing6.EffectofondigastricsystemBleedingParalysis 瘫痪LeadingdifficultybreathingdietworseoralhygieneAsphyxia窒息2026/2/10167.Multi-sinus

-contamination

InfectionOralcavityNasalcavityPharyngealcavityOrbitParanasalsinusBacteriaTempHumidity2026/2/10178.DamagetospecificstructureParotidGlandFacialN.TrigeminalN.SalivaryfistulaFacialparalysisRegionalnumbness2026/2/10189.FacialDefect

FacialcontourPsychologicaltrauma2026/2/1019EvaluatetraumasoonIdentifythekeytrauma,managethefatalfirstCarefulhistorytaking,thoroughphysicalexamRescueintimeManagementinorderGeneralRulesSection3Rescue2026/2/10201.PreventionofAsphyxiaSection3Rescue2026/2/1021Dysphoria,sweating,inhalingrespirationDifficulttoinhale,hypopnea,nasalalarmovement,labialcyanosisThreeconcavesigns、Rapidbreathing,weakpulse,decreasedBPPupilsdiluted,Noreflectiontolight1.1ClinicalfeaturesofasphyxiaProdrome2026/2/10221.2

EtiologyofAsphyxia

ForeignbodyobstructionInspiratoryAsphyxiaLowAirwaySwellingForeignbodyBlood,salivaVomitUpperairwayTissuedislocation

ObstructiveAsphyxia2026/2/10231.3

RescueofAsphyxiaClearforeignbodyinupperairwaySuspendmaxillaIntubationHoldthetongueoutObstructiveAsphyxia吸入性窒息气管切开术2026/2/1024

2.HemostasiaTwosteps：JudgebleedingsituationChoosethewaytostopbleedingSection3Rescue2026/2/10252.1

JudgebleedingsituationThreecategoriesArterialCapillaryVenousBasedonorigin2026/2/1026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

Methodsofhemostat2026/2/10273.Anti-shocktreatment(2)

Purposeofanti-shock(1)

Definition&Classification

TraumaticshockExsanguineshock

>20%BodyweightToxicshockInfectiousshock

Restorecirculation2026/2/1028(4)

PrinciplesofTreatment

(3)

FeaturesofShockEarlystage:Dysphoria,quick&superficialbreath,sweating,palenessMiddlestage:Tingletosupression,emotionalfaint,unconsciousness,decreaseBP,labialpalenessLatestage:weakerpulsation,unmeasurableBP,hyponuria,anuria<30ml/hHemostasis,bloodtransfusion,paincontrol,fluidtransfusion,sedation2026/2/1029(1)

Judgement4.CombinedCraniocerebralInjuriesConsciousness,pulse,BP,respiration,pupil(2)Earlydiscovery,earlymanagementRetrogradeobliviscence CerebralconcussionIntermediatewake-up ExtraduralhematomaCerebralfluidleak Skullbasefracture2026/2/10302026/2/1031DebridementWoundclosureAntibiotics5.PreventionofInfection6.Bandage&Transportation2026/2/1032

Section4SoftTissueTrauma2026/2/1033Abrasions 擦伤Contusions 挫伤Contusions&Lacerations 挫裂伤Incised&PunctureWound 切割伤及刺伤BiteWound

咬伤TypesofinjuriesSection4SoftTissueTrauma2026/2/1034Character:Irregularwoundedge,foreignbody,pain,oozing&yellowishplasmaoozingManagement:Debridement,removeforeignbody,Drywound,drainwheninfected1.AbrasionsProperty:roughsurfaceEpidermis&superficialdermis2026/2/10351.Abrasions2026/2/10362.ContusionsCharater:petechia,swelling,painManagement:

HemostasisPain-killerPreventionofinfectionHematomaresorptionRe-establishmentoffunctionProperty:bluntmaterial&felltohardobjectSubdermaltissue(noopenwound)2026/2/1037Property:Bluntobjectwithhighmechanicalforce3.Contusions&LacerationsCharacterIrregularwoundedge,saw-toothedBiglacerationw/wonecrotictissue&openfracturesManagementDebridementWoundClosureSofttissue2026/2/10383.Contusions&Lacerations2026/2/1039Property:Sharpobjectorinstruments4.Incised&PunctureWoundCharater

RegularwoundedgeBleedingSmallaccess,butdeepwoundManagementDebridementWoundclosureSofttissue2026/2/1040Property:Animal(Wolf,dog,Bear)orhumanbeingsCharacterToothtracedHeavycontaminationTendtoinfectionManagementThoroughdebridementInfectioncontrolSkingraftaftergranulartissueregeneratedVaccinationofTetanus,Rabies5.BiteWound2026/2/1041DefinitionDebridement

MainEntry:de·bride·ment

Pronunciation:di-'brEd-m&nt,dA-,-"mänt,dA-brEd-'män

Function:

noun

Etymology:Frenchdébridement,fromdébridertoremoveadhesions,literally,tounbridle,fromMiddleFrenchdesbrider,fromdes-de-+bridebridle,fromMiddleHighGermanbrIdel--moreatBRIDLE

:thesurgicalremovaloflacerated,devitalized,orcontaminatedtissue2026/2/1042Protocol1.washwound

Time：6--12h

Solution:soapwater,saline,hydrogendioxideDebridement3.Closure2.Cleanwound

Removalofforeignbody Trimmingofnecrotictissue2026/2/10432026/2/1044CheekinjuriesPalateinjuriesInjuriesatotherregionsManagementofsofttissureinjuriesTongueinjuriesLengthmaintain,longitudinalclosureIndependentclosure,buttonguesuturedominationBigneedlewithbig,depthsuturingormatricsuturing2026/2/1045Managementofsofttissureinjuries2026/2/10462026/2/1047Section5InjuryofTeethandDentalAlveolarProcess2026/2/10481.Toothinjuries

1.1ContusionofTeethEtiology:Extrinsicforce blunttoothinjuries

PeriodontalligamentsordentalpulpCharacter:ExtrusionoftoothMobilityPercussion&ToothachewhenchewingManagementToothrestToothgroundSimpleligation2026/2/10491.Toothinjuries

1.2LuxationofTeethClassificationCharacterToothdislocatedorexfoliatedManagementToothprotectionpriorityReductionFixationReimplantationPartialluxationCompleteluxation-Toothdislocation-Semiluxation-Intrusivemovement2026/2/1050Gingivalorlabialswelling,lacerationAdjacentteethoralv