局部刮治、瘘管内上药联合治疗难愈型根尖瘘管疗效分析

Analysis of effect of local curettage combined with ointment in fistula applying in refractory apical fistula

目的：观察局部刮治联合瘘管内上药在难愈型根尖瘘管治疗中的治疗效果。方法将已进行完善根管治疗1个月后根尖瘘管仍未愈合的56例难愈型根尖瘘管患者按抽签法随机分为A、B两组，每组各28例。A组采用瘘管局部进行刮治联合瘘管内上药，B组不作任何处理。继续随访观察至根管治疗后1年，比较两组治疗效果。结果 A组中28例难愈型瘘管均在3个月内痊愈，好转率100％，痊愈率100％，瘘管消失时间（0．5±0．1）个月，X线片显示根尖阴影消失时间（2．5±0．7）个月。B组中28例难愈型瘘管3个月内好转4例，6个月内好转3例，9个月内好转1例，其中2例痊愈，好转率28．57％，痊愈率7．14％，瘘管平均消失时间（5．0±0．7）个月，X线片显示根尖阴影消失时间（9．4±1．0）个月。A组患者好转率高于B组（χ2＝33．749，P＜0．05），A组患者痊愈率高于B组（χ2＝49．727，P＜0．05），A组瘘管平均消失时间短于B组（t＝3.081，P＜0．05），A组根尖阴影消失时间短于B组（t＝5．042，P＜0．05）。结论采用局部刮治联合瘘管内上药治疗难愈型根尖瘘管效果确切，值得临床推广。

Objective To observe the effect of local curettage combined with ointment in fistula applying in refractory apical fistula.Methods 56 cases of patients with refractory apical fistula one month after faultless root cannal therapy divided into group A and B by lottery,with 28 cases in each group.Local curettage combined with ointment in fistula applying in group A,and no processing applying in group B.One year fellow up was given to every patient to compare the effect between the two groups.Results All the 28 cases of patients with refractory apical fistu-la were recovering in three months.The improvement rate was 100%,recovery rate 100%,and the mean time of fistula disappearing was （0.5 ±0.1）months,time of shadow around root tip disappearing （2.5 ±0.7）months.Four cases in group B were improved in three months,three cases in six months and one case in nine months,with two cases recove-ring.The improvement rate was 28.57%,recovery rate was 7.14%,and the mean time of fistula disappearing was （5.0 ±0.7）months,time of shadow around root tip disappearing （9.4 ±1.0）months.The improvement rate in group A was higher than that in group B （χ2 =33.749,P〈0.05）,recovery rate in group A was higher than that in group B （χ2 =49.727,P〈0.05）.The mean time of fistula disappearing in group A was shorter than that in group B （t=3.081,P＆lt;0.05）,mean time of shadow around root tip disappearing in group A was shorter than that in group B （t=5.042,P〈0.05）.Conclusion It was effective to apply local curettage combined with ointment in fistula applying in refractory apical fistula,and it is worthy of clinical popularization.