内镜下上颌窦内提升术的实验研究

Endoscopic lift of the maxillary sinus floor in Beagle dogs

目的:介绍一种应用于Beagle犬的内镜辅助下上颌窦内提升术。方法:随机挑选6只犬,分为实验组和对照组,实验组行改良内镜上颌窦内提升术,对照组则为冲击式内提升术。全部手术由2个安全指标(上颌窦黏膜穿孔、鼻出血)和3个效果指标(术中提升高度、移植骨体积、上颌窦内移植骨的前后位置)进行评价,利用SAS 9.0软件包对实验数据进行Wilcoxon符号秩和检验。结果:实验组及对照组均未出现上颌窦黏膜穿孔和鼻出血。实验组术中提升高度为(13.7±0.8)mm,对照组为(9.1±0.5)mm,2组差异显著(P=0.0001)。实验组移植骨量为(0.9±0.04)m L,对照组为(0.5±0.02)m L,2组差异显著(P=0.0001)。实验组前部移植骨体积较后部骨体积无显著差异(P=0.103),而对照组两者存在显著差异(P=0.002)。结论:在内镜辅助下直视完成犬上颌窦内提升术,是一种安全、有效、快捷的方法。

PURPOSE： To introduce a modified endoscopic lift of the floor of the maxillary sinus in Beagle dogs.METHODS： Twelve operations（bilateral and randomly chosen） were done in 6 Beagle dogs in the experimental group（modified endoscopic operation） and the control group, in which the operation was done with an osteotome. All operations were evaluated by 2 indices of safety（perforation of the sinus membrane and nasal bleeding） and 3 effective indices（intraoperative height after lifting, volume of bone grafts, and dislocation of the sinus grafts）. Wilcoxon sign rank test was conducted using SAS 9.0 software package. RESULTS： The intraoperative height after lifting was（13.7 ±0.8） mm in the experimental group and（9.1±0.5） mm in the control group, significant difference existed between the 2 groups（ P=0.0001）.Similarly, the volume of bone graft was（0.9±0.04） m L in the experimental group and（0.5±0.02） m L in the control group（P=0.0001）. The volume of the anterior and posterior bone grafts in the implant cavity in the experimental group had no significant difference（P=0.102）, while there was significant difference in the control group（P=0.002）. CONCLUSIONS：Endoscopic lifting of the floor of the maxillary sinus is a safe and effective approach based on direct observation in Beagle dogs.