口腔颌面部间隙感染患者手术干预需求的危险因素分析

doi:10.13591/j.cnki.kqyx.2026.03.005

摘要/Abstract

摘要：

目的探究口腔颌面部间隙感染(oral and maxillofacial space infection,OMSI)患者需要手术干预的相关危险因素。方法选取本院治疗的18例接受手术干预的OMSI患者作为实验组,同时选取同期收治的24例仅接受抗生素治疗好转的OMSI患者作为对照组。统计患者基本人口统计学特征、初诊血清学指标(血常规、CRP及复合血清学指标包括NLR、PLR)、临床症状及系统性疾病史,回顾性分析口腔颌面部间隙感染患者手术干预需求的危险因素。结果单因素分析中两组间的基本人口统计学特征(年龄及性别)、临床症状(是否影响呼吸及吞咽、是否伴张口受限)和系统性疾病史(糖尿病史及心血管疾病史)差异无统计学意义(P>0.05),中性粒细胞百分数、淋巴细胞绝对数、单核细胞绝对数、NLR组间差异显著(P<0.05)。多因素Logistic回归模型中,中性粒细胞百分数、单核细胞绝对数和NLR保留为手术干预结局的危险因素。ROC曲线分析中模型曲线下面积(AUC)为0.86(95%置信区间:0.75~0.97)。Hosmer-Lemeshow检验P=0.604(P>0.05),拟合优度良好。结论口腔颌面部间隙感染患者初诊血清学指标中异常的中性粒细胞百分数、单核细胞绝对数及NLR高值是后期手术干预需求的危险因素。

关键词: 口腔颌面部间隙感染, 危险因素, 手术干预, 回顾性分析

Abstract:

Objective To investigate the risk factors associated with the need for surgical intervention in patients with oral and maxillofacial space infection(OMSI). Methods A total of 18 OMSI patients who underwent surgical intervention in our hospital were selected as the experimental group, and 24 OMSI patients who improved with only antibiotic treatment during the same period were selected as the control group. Statistical analysis was performed on patients’ baseline demographic characteristics, initial serological markers(including complete blood count, CRP, and composite indices such as NLR and PLR), clinical symptoms, and systemic disease history to retrospectively identify risk factors for surgical intervention in patients with orofacial space infections. Results In the univariate analysis, there were no significant differences(P>0.05)in baseline demographic characteristics(age and gender), clinical symptoms(whether respiration and swallowing were affected, and whether trismus was present), and history of systemic diseases(diabetes mellitus and cardiovascular disease) between the two groups.However, significant differences were observed in the percentage of neutrophils, absolute number of lymphocytes, absolute number of monocytes, and NLR between the groups(P<0.05). In the multivariate binary Logistic regression model, the percentage of neutrophils, absolute number of monocytes, and NLR were retained as risk factors for surgical intervention outcomes. The area under the ROC curve(AUC) was 0.86(95% confidence interval: 0.75-0.97). The Hosmer-Lemeshow test showed a P-value of 0.604(P>0.05), indicating a good fit of the model. Conclusion Abnormal levels of neutrophil percentage, absolute number of monocytes, and high NLR in the initial serological indicators of patients with oral and maxillofacial space infections are risk factors for the need for surgical intervention later on.

Key words: oral and maxillofacial space infection, risk factors, surgical intervention, retrospective analysis

中图分类号:

R782.3

吕中静, 袁健. 口腔颌面部间隙感染患者手术干预需求的危险因素分析[J]. 口腔医学, 2026, 46(3): 189-194.

LYU Zhongjing, YUAN Jian. Analysis of the risk factors for surgical intervention in patients with oral and maxillofacial space infections[J]. Stomatology, 2026, 46(3): 189-194.

图/表 7

表1

表2

OMSI患者基线特征及手术需求的单因素筛查分析"

研究变量		总计(n=42)	非切排(n=24)	切排(n=18)	统计值	P
年龄/岁,$\overline{x}$±s		53.76±20.00	55.62±19.13	51.28±21.40	t=0.69	0.493
性别,n(%)	男	26(61.90)	13(54.17)	13(72.22)	χ²=1.42	0.233
	女	16(38.10)	11(45.83)	5(27.78)
白细胞计数,n(%)	异常	32(76.19)	16(66.67)	16(88.89)	χ²=1.71	0.191
	正常	10(23.81)	8(33.33)	2(11.11)
中性粒细胞绝对数n(%)	异常	36(85.71)	19(79.17)	17(94.44)	χ²=0.91	0.340
	正常	6(14.29)	5(20.83)	1(5.56)
中性粒细胞百分数,n(%)	异常	27(64.29)	12(50.00)	15(83.33)	χ²=4.98	0.026^*
	正常	15(35.71)	12(50.00)	3(16.67)
淋巴细胞绝对数,n(%)	异常	11(26.19)	0(0.00)	6(33.33)	χ²=6.81	0.009^*
	正常	31(73.81)	24(100.00)	12(66.67)
淋巴细胞百分数,n(%)	异常	36(85.71)	19(79.17)	17(94.44)	χ²=0.91	0.340
	正常	6(14.29)	5(20.83)	1(5.56)
血红蛋白,n(%)	异常	10(23.81)	4(16.67)	6(33.33)	χ²=0.79	0.374
	正常	32(76.19)	20(83.33)	12(66.67)
血小板,n(%)	异常	6(14.29)	4(16.67)	2(11.11)	χ²=0.00	0.949
	正常	36(85.71)	20(83.33)	16(88.89)
红细胞比容,n(%)	异常	20(47.62)	12(50.00)	8(44.44)	χ²=0.13	0.721
	正常	22(52.38)	12(50.00)	10(55.56)
嗜酸性粒细胞百分数,n(%)	异常	25(59.52)	12(50.00)	13(72.22)	χ²=2.11	0.147
	正常	17(40.48)	12(50.00)	5(27.78)
红细胞计数,n(%)	异常	14(33.33)	7(29.17)	7(38.89)	χ²=0.44	0.508
	正常	28(66.67)	17(70.83)	11(61.11)
嗜酸性粒细胞绝对数,n(%)	异常	14(33.33)	6(25.00)	8(44.44)	χ²=1.75	0.186
	正常	28(66.67)	18(75.00)	10(55.56)
单核细胞百分数,n(%)	异常	3(7.14)	2(8.33)	1(5.56)	χ²=0.00	1.000
	正常	39(92.86)	22(91.67)	17(94.44)
单核细胞绝对数,n(%)	异常	31(73.81)	14(58.33)	17(94.44)	χ²=5.20	0.023^*
	正常	11(26.19)	10(41.67)	1(5.56)
NLR,$\overline{x}$±s		8.04±7.31	5.53±3.78	11.40±9.41	t=-2.78	0.008^*
PLR,$\overline{x}$±s		193.83±90.92	188.33±100.01	201.16±79.42	t=0.45	0.656
C反应蛋白,n(%)	异常	34(80.95)	18(75.00)	16(88.89)	χ²=0.54	0.461
	正常	8(19.05)	6(25.00)	2(11.11)
是否影响呼吸,n(%)	是	1(2.38)	0(0.00)	1(5.56)	χ²=0.02	0.884
	否	41(97.62)	24(100.00)	17(94.44)
是否影响吞咽,n(%)	是	6(14.29)	2(8.33)	4(22.22)	χ²=0.69	0.408
	否	36(85.71)	22(91.67)	14(77.78)
是否伴张口受限,n(%)	是	16(38.10)	8(33.33)	8(44.44)	χ²=0.17	0.680
	否	26(61.90)	16(66.67)	10(55.56)
是否有糖尿病史,n(%)	是	4(9.52)	2(8.33)	2(11.11)	χ²=0.08	0.781
	否	38(90.48)	22(91.67)	16(88.89)
是否有心血管疾病史,n(%)	是	3(7.14)	2(8.33)	1(5.56)	χ²=0.00	1.000
	否	39(92.86)	22(91.67)	17(94.44)

表2

表3

图1

图2

图3

图4

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感染部位	总计(n=42)	非切排(n=24)	切排(n=18)
颌下间隙	30(71.43%)	17(70.83%)	13(72.22%)
咬肌间隙	14(33.33%)	9(37.50%)	5(27.78%)
颞间隙	1(2.38%)	0(0.00%)	1(5.56%)
眶下间隙	3(7.14%)	3(12.50%)	0(0.00%)
颊间隙	8(19.05%)	5(20.83%)	3(16.67%)
翼颌间隙	3(7.14%)	1(4.17%)	2(11.11%)
颏下间隙	7(16.67%)	2(8.33%)	5(27.78%)
舌下间隙	2(4.76%)	2(8.33%)	0(0.00%)
咽旁间隙	4(9.52%)	0(0.00%)	4(22.22%)
单间隙	22(52.38%)	13(54.17%)	9(50.00%)
多间隙	20(47.62%)	11(45.83%)	9(50.00%)

研究变量	β	SE	Z	P	OR(95%CI)
截距项	-4.68	1.52	-3.08	0.002^**
中性粒细胞百分数
正常					1.00(参考值)
异常	1.33	0.88	1.51	0.132	3.78(0.67~21.26)
单核细胞绝对数
正常					1.00(参考值)
异常	2.66	1.19	2.23	0.026^*	14.34(1.38~148.82)
NLR	0.18	0.11	1.71	0.086	1.20(1.01~1.53)