侵犯上颌窦的颌骨囊肿术后两种引流方式的临床效果观察

Clinical effect of two kinds of drainage methods after surgery for jaw cyst with infringement of maxillary sinus

目的观察不同引流方式在侵犯上颌窦的颌骨囊肿患者术后中的应用效果。方法选择2002年7月至2012年10月在广东医学院附属韶关市第一人民医院口腔颌面外科治疗的34例侵犯上颌窦的颌骨囊肿患者,A组(n=17)采用术后严密缝合创口加明胶海绵填塞上颌窦腔引流;B组(n=17)则采用严密缝合创口、脱细胞异体真皮基质(Acellular dermal matrix,ADM)补片衬垫及加碘仿纱条填塞上颌窦腔引流。采用SPSS13.0软件包对数据进行统计学分析。结果手术后第2天,A组术后重度肿胀的发生率(52.9%)明显高于B组(11.8%),差异有统计学意义(χ2=4.838,P<0.05)。拆线后1周复诊,A组上颌窦瘘的发生率(35.3%)高于B组(5.9%),差异有统计学意义(χ2=5.060,P<0.05)。结论侵犯上颌窦的颌骨囊肿术后用ADM补片衬垫,碘仿纱条填塞引流,可减轻术后肿胀程度,降低上颌窦瘘的发生率。

Objective To observe the clinical effect of two different drainage methods after surgery for jaw cyst with infringement of maxillary sinus. Methods Thirty-four patients of jaw cyst with infringement of maxillary sinus treated in the First People＇s Hospital of Shaoguan Affiliated to Guangdong Medical College from July 2002 to October 2012 were selected and divided into two groups： group A （n=17） and group B （n=17）. In group A, the incision was closed intensively by suture and the cavity of maxillary sinus was filled with gelatin sponge. In group B, the inci- sion was closed intensively by suture and the cavity of maxillary sinus was padded with acellular dermal matrix （ADM） and filled with iodoform gauze strip. All data were analyzed by SPSS13.0 software package. Results The in- cidence of severe swelling in group A （52.9%） was significantly higher than that in group B （11.8%） two days postop- eratively （x^2=4.838, P〈0.05）. One week after taking out stitches, the incidence of maxillary sinus fistula in group A （35.3%） was significantly higher than that in group B （5.9%）, x^2=5.060, P〈0.05. Conclusion The cavity is padded with acellular dermal matrix and filled with iodoform gauze strip after surgery for jaw cyst with infringement of maxil- lary sinus. The method can reduce the incidence of maxillary sinus fistula and complieatious, which is worthy of clini- cal applieation.