연세대학교 치과병원에 내원한 야간응급환자의 임상적 연구

A CLINICAL STUDY ON NIGHTTIME EMERGENCY PATIENTS OF THE DENTAL HOSPITAL, YONSEI MEDICAL CENTER

This is a retrospective study on nighttime emergency patients. The study was based on a series of 1,029 patients treated as nighttime emergency patients at dental hospital, Yonsei medical center from Jan. l, 1980, to Dec. 31 ,1984. The obtained results were as follows : 1. Yearly increased emergency patients rate was 22% and the highest monthly distribution showed in October. The age distribution ranged from 8 months to 80 years with the peak incidence occurring in the 20- to 30- year age group (32.4%) and the ratio of male to female was 2.3 : 1. Trauma (76.3%) was the most frequent cause in nighttime emergency and dentoalveolar hemorrhage (7.5%) and acute odontogenic infection (7.3%) were next in order of frequency. According to the analysis by the districts, 39.5% of the total patients resided in Seo Dai Mun ku, Ma Po ku, and Eun Pyung ku near this hospital. 72.9% of the total patients visited directly to the emergency room. 2. In the trauma group, peak incidence occurred in the 20- to 30- year group (31.2%) and the ratio of male to female was 2.6 : 1. Falls (43.2%) was the most frequent cause, followed by fight (27.6%) and traffic accident (21.9%). Frequent sites of soft tissue injury were upper and lower lip and gingiva. Simple laceration (85.4%) was the most common type of soft tissue injury. As to the teeth and alveolar injury, the most common site was the upper anterior region (69.6%). Luxation of tooth (48.4%) was the most common type. The most common site of facial bone fractures was mandible (76.1%), zygoma complex 14.4%), maxilla (8.0%) in order. Frequent fracture sites of mandible were symphysis (50.0%) and angle region (20.6%). 77 cases (42.3%) were treated by open reduction, 56 cases(30.8%) were treated by closed reduction and 49 cases (26.9%) were examined only. 3. In the acute odontogenic infection group, acute cellulitis (54.7%) was the most common for the nighttime emergency call and the infection of lower 3rd molar (32%) was the most common etiologic factor. 4. In the dentoalveolar hemorrhage group, a major cause was postoperative hemorrhage (72.9%) and hemostasis was obtained by pressure dressing mainly (46.8%). All 18 cases of the complicated exodontics group were transferred from local dental clinics for the failure of removal of fractured roots and condemned tooth was the lower 3rd molar (83.3%) mostly. 5. In the TMJ dislocation group, the peak incidence showed in the 20- to 30- year group (40.7%) and acute pulpitis (70.2%) was the most common and its frequent site was 1st molar (33.3%) in other group.