摘要
目的:对3576例张口受限病例进行临床回顾分析。方法:回顾性分析中山大学附属口腔医院1997年至2017年间住院治疗的张口受限住院患者资料,明确发病年龄、性别、病因、及误诊漏诊的情况。结果:张口受限患者以20-29岁组最多,但总体年龄分布无明显高峰,男性高于女性,近年来男性占比有上升趋势,近10年男性患病占比增幅为5.68%。颌面部创伤为主要致病原因,占30.46%,前后十年对比,颞下颌关节疾病患者数量增长迅速,已经成为张口受限的主要致病原因(29.57%);易误诊漏诊的疾病主要为隐秘部位如鼻咽、口咽部肿瘤或颞下颌关节区肿瘤等,常被误诊为颞下颌关节紊乱病(TMD)。结论:近10年颞下颌关节疾病已经取代颌面部损伤成为张口受限的主要致病原因,张口受限患者中误诊漏诊多为隐秘部位肿瘤被诊断为TMD,其中不乏恶性肿瘤患者,临床工作中应重视影像学检查,尤其是对于保守治疗效果不佳或症状不典型的患者应视病情早行CT或MR检查。
Objective： This clinical retrospective study is aimed to offer the clinical epidemiologic information about mouth opening limitation based on 3576 cases. Methods： From 1997 to 2017, 3576 mouth opening limitation cases were treated in Hospital of Stomatology Sun Yat-sen University. Dataing regarding age, gender, occupation distribution of this disease, etiological factors, and misdiagnosis. Results： The age group 20-29 has the biggest amount but there is no peak during age distribution, and male cases were more than female ones. The most common cause of mouth opening limitation was maxillofacial traumatic. The constituent of male increased 5.68% in ten years. Temporomandibular joint disorder（TMD） cases increased quickly in the last ten years and become the main pathogenic factor of mouth opening limitation;There are many misdiagnosis of mouth opening limited patients. The most common diseases are maxillofacial tumor（NPC,multiple cancer, etc.） and TMJ disease（synovial chondromatosis）. Most of them were misdiagnosed as temporomandibular disorders（TMD）. Concusion： Temporomandibular disease had replaced maxillofacial traumatic became the most common cause of mouth opening limitation in ten years; Image diagnosis is very important to mouth opening limitation patients especially when conservative treatment is ineffective.
作者
王周涛
郑有华
何一青
苏凯
贾嘉欣
张志光
WANG Zhou-tao;ZHENG You-hua;HE Yi-qing;SU Kai;JIA Jia-xin;ZHANG Zhi-guang(Guanghua School of Stomatology,Hospital of Stomatology Sun Yat-sen University,Guangdong Provincial Key Laboratory of Stomatology,Guangdong 510055,China)
出处
《口腔颌面修复学杂志》
2018年第3期144-147,共4页
Chinese Journal of Prosthodontics
基金
卫生部临床重点项目(卫规财行[2010]439号)
关键词
张口受限
回顾性研究
诊断
month opening limitation
retrospective study
diagnosis
