PARTICULARITIES OF THE CLINICAL COURSE AND SURGICAL TACTICS IN BAKTERIOIDICAL INFECTIONS AT MAXILLOFACIAL AREA
PARTICULARITIES OF THE CLINICAL COURSE AND SURGICAL TACTICS IN BAKTERIOIDICAL INFECTIONS AT MAXILLOFACIAL AREA
Mirzoev M.Sh., Shakirov M.N., Gafarov Kh.O., Khushvakhtov D.I.
Depertment of Maxillofacial Surgery with Children's Stomatology of State Educational Establishment «Institute of Postgraduate Education in Health Sphere of Republic of Tajikistan»
Aim. To study the particularities of the clinical course and surgical tactics treatment of the festering-inflammatory processes of maxillofacial area and necks, caused bakterioidical infections.
Materials and methods. A complex examination of 32 patient have been organized with rotten necrotic processes of the maxillofacial area and neck at the age of '21 to 60 years. Of the total number of patients men accounted for 18, women — 14. For the majority of patients (27 — 84,3%) the cause of the inflammatory process were unsanitated chronic foci of infection in the oral cavity, and in 5 (15,7%) — causes of nonodontogenic etiologies.
The general clinical laboratory and special methods of investigations were conducted to all enrolled patients as a matter of urgency. The list of laboratory studies included: blood and urine tests on sterility, sensitivity of identified microorganisms to antibiotics, determination of the degree intoxication of an organism on the leukocyte index Kalf-Caliph immunological status on indicators of T-lymphocytes, as well as the study of multiple organ shifts on biochemical indicators of blood. In recent years, at connection with the emerging opportunities the main method of the research in this category of patients were studying KHS and blood gases. Additional methods included conducting ECG, ultrasound, digital orthopantomography of jaws, and by indications and computer tomography-CT lung.
Results. In most cases (26 — 81,2 %) patients arrived to the hospital in serious condition. Moreover, in 21 patients (65,7%) the rotten- necrotic process in all cellular spaces of the maxillofacial area with the preferentially localization in the bottom of their mouth had spread, and in 11 (34,3%) patients at the process additionally the deep fascial-cellular spaces of the neck were involved. Based on clinical datas in 4 patients initially the front mediastinitis was recognized, and two of them died in the first days of its receipt (income).
Conclusion. The success of surgical treatment of rotten necrotic processes of the maxillofacial area and neck depends not only on the broad opening of purulent wounds, but from the knowledge of clinical signs of development asporogenic anaerobic infections, which allow doctors promptlyeven before the bacteriological identification, to establish a presumptive diagnosis, choose the correct tactics of treatment, and thereby prevent further spread of the inflammatory process and the appearance of life-formidable complications of the patient.
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