下颌阻生第三磨牙拔除术后疼痛、张口受限及肿胀之分析

Analysis on Pain, Edema and Trismus after Extracting Impacted Mandibular Third Molar.

目的 探讨下颌阻生第三磨牙拔除术后的疼痛、张口受限及肿胀与手术难度的关系。方法 收集 1 2 4例下颌阻生第三磨牙拔除术的病例 ,按手术难度分为三组 ,分别于术后第二日及第七日分析三者之间的疼痛、张口受限及肿胀差异。结果 三组的大部分病例均发生了张口受限、疼痛及肿胀反应 ,术后第二日及第七日三组间张口受限差异无统计学意义。术后第二日 ,挺出组疼痛分级程度较其它两组轻 ,而切开组与去骨组疼痛分级无差异 ;术后第七日 ,去骨组仍有疼痛的比例较高 ,而切开组与挺出组间则无差异。术后第二日及第七日 ,去骨组及切开组之肿胀分级均较挺出组为高 ,在去骨组与切开组间则均无差异。结论 下颌阻生第三磨牙拔除术后均有可能发生张口受限、疼痛及肿胀反应。张口受限与手术难度无关 ,软组织损伤小者 ,术后疼痛较轻 ,去骨无加重疼痛 ,但疼痛缓解较慢。软组织的损伤程度与肿胀的发生及缓解有关联 。

Objective To analyse the relationship between pain,edema, trismus and operation difficulty after extracting mandibular third molars.Method According to extraction difficulty, 124 cases whose impacted mandibular third molar should be removed were divided into three groups. The difference of pain,edema and trismus was analysed statistically among three groups on the 2nd and 7th postoperative day respectively.Result Most of the cases developed pain,edema and trismus postoperatively,and the reactions relieved with the time.The difference of trismus among three groups were no statistic significance on either the 2nd or 7th postoperative day. On the 2nd postoperative day, the scale of pain classification in group 1 was less severe statistically than that in other two groups,but it was no difference between group 2 and 3. On the 7th postoperative day,the proportion of pain was higher statistically in group 3 than that in other 2 groups, it was no difference between group 1 and group 2. Pain in 19% cases of total would not relieve completely on the 7th postoperative day. On either 2nd or 7th postoperative day,the scale of edema classification in group 2 and 3 was always higher than that in group 1 statistically, but it was no difference between the former two groups. On the 7th postoperative day, the edema is 16 cases of total would not relieve completely. Conclusion The pain, edema and trismus may be developed after extracting mandibular third molar. It has no relationship between trismus and extraction difficulty. The less soft tissue is damaged, the less pain is developed. The pain can not be intensified by excising bone, but pain will relieve more slowly when excising bone. The damaging degree of soft tissue is related to the developing and relieving of edema, but whether or not excising bone is not related to it.