颌骨囊性病变开窗减压术及义齿式囊肿塞的应用与疗效观察

Marsupialization in the treatment of jaw cystoid disease and application and curative effect observation of denture type cyst plug

目的研究颌骨囊性病变采用开窗减压术和刮治截骨术的治疗效果及义齿式囊肿塞的应用。方法 81例颌骨囊性病变患者,分别采用开窗减压术(36例)和刮治截骨术(45例),比较两组术中相关情况和术后并发症及复发情况。采用SPSS 13.0统计软件进行统计分析,资料以x±s表示,对两种治疗方法手术用时、出血量、受累牙拔除、下唇麻木情况及术后治疗效果与复发率采用χ2检验进行比较分析,P<0.05为差异有统计学意义。结果开窗减压术患者手术时间为(31.2±4.1)min,术中出血量为(20.3±7.2)ml、受累牙拔除为(0.7±0.04)个,术后疼痛、下唇麻木、感染及术后3年咀嚼功能下降等指标均明显低于刮治截骨术患者,差异有统计学意义(P<0.05),而术后3年刮治截骨术组有6例面形发生轻度不对称,2例复发(4.44%),开窗术组无面形改变和复发,复发率差异无统计学意义(P>0.05)。结论开窗减压术手术创伤小、并发症少,保留了颌骨的完整性及病变区的患牙,相对应刮治截骨术是一种简单实用有效的方法。

Objective To evaluate and compare the clinical results of marsupialization and curettage in the treatment of jaw cystoid disease,and application of the denture type cyst plug. Methods Eighty-one patients with jaw cystoid disease were treated with marsupialization（36 cases）or curettage（45cases）. The correlation of the two groups was compared,and the postoperative complications and recurrence were compared. Data was statistically analyzed using SPSS 13.0. Data was listed as x ± s.Operation time,blood loss,retention affected teeth,numbness of the lower lip,treatment effect and recurrence rate of two treatments were analyzed using the χ~2 test. Results Operation time for patients treated with marsupialization was（31.2 ± 4.1）min,the amount of bleeding during operation was（20.3 ±7.2）ml,affected teeth extraction was（0.7 ± 0.04）,postoperative pain,numbness of lower lip,infection,and masticatory function decline index were significantly lower than the curettage group 3 years after surgery. The difference was statistically significant（P〈0.05）. Three years after surgery the curettage group was found slight asymmetry of facial shape in 6 cases and 2 recurrence cases（4.4%）. No surface shape change and recurrence was seen in the marsupialization group. There was no significant difference in the recurrence rate of the two groups（P〈0.05）. Conclusion Comparing with curettage,marsupialization is a simple,practical and effective method with less damage,complications. and keep the jaw and teeth in the affected area intact.