Clinical and Laboratory Indicators in Patients with Infectious Processes of the Maxillofacial Area and Neck

According to various authors, patients with infectious and inflammatory processes of the maxillofacial area and neck make up to 50% of persons undergoing treatment in the departments of specialized hospitals. The purpose of the study was to identify clinical and laboratory changes in patients with infectious processes of the maxillofacial area and neck. Material and methods. The group of patients was divided into 4 subgroups: the 1st subgroup (40 people) comprised patients with the acute purulent odontogenic jaw periostitis, the 2nd subgroup (96 people) included patients with the acute purulent odontogenic jaw osteomyelitis complicated by phlegmon of one cellular space, the 3rd subgroup (36 people) had patients with the acute purulent odontogenic osteomyelitis of the jaw, complicated with phlegmon of 2-4 cellular spaces, and the 4th subgroup (26 people) included patients with the acute purulent odontogenic osteomyelitis of the mandible, complicated with phlegmon of the mouth floor. We recorded the duration of hospitalization of patients, the rise in body temperature, the duration of antibiotic therapy, heart rate and respiration rate on the day of hospitalization. The state of the purulent wound was assessed daily, several terms were fixed: the day of pain ending, the day of face configuration recovery, the day of the skin hyperemia ending, the day of exudation ending, the day of granulation tissue growth. Patients had general blood test for laboratory examination. On the basis of their results we made the calculation of the integral indices of intoxication was carried out with their subsequent interpretation. Results and discussion. With the development of infectious and inflammatory process of maxillofacial region and neck of odontogenic etiology, the body temperature of patients was 37.8 (37.5-38) °C during the treatment. Heart rate was equal to 82 (74-90) beats per minute, respiration rate was 17 (17-18) per minute. The assessment of local clinical manifestations revealed the absence of pain in palpation of the inflammatory focus on the 7-th (6-9) day, the facial configuration was restored on the 8-th (6-10) day, the absence of edema and hyperemia in the wound area was stated on the 6-th (4-8) day, purulent exudation was stopped on the 6th (4-8) day, the growth of granulations was stated on the 7-th (5-9) day. The duration of inpatient treatment for patients with the acute purulent odontogenic jaw periostitis was 6 (4.5-8) days; for patients with the acute odontogenic osteomyelitis of the jaw complicated by phlegmon of one cellular space it was 9 (7-11) days; for patients with the acute odontogenic osteomyelitis complicated by phlegmon 2-4 cellular spaces it was 10 (8,5-14) days; and for patients with the acute odontogenic osteomyelitis complicated by complicated by phlegmon of the mouth floor it was 13 (12-17) days. The nuclear index and index of the ratio of leukocytes and the erythrocyte sedimentation rate statistically significantly increased and lymphocytic-granulocyte index decreased with a greater spread of infectious and inflammatory process of the maxillofacial area and neck. Conclusion. The obtained results of the clinical and laboratory parameters allowed us to evaluate the effectiveness of the newly proposed and improved methods of treatment of infectious and inflammatory diseases of the maxillofacial region and neck using the most informative diagnostic tests.