硫酸钙修复颌骨囊肿术后感染原因分析及处理措施

Analysis of the cause of infection and treatment with medical calcium sulfate bone particle for repair of jaw cysts

目的 :分析医用硫酸钙骨粒修复颌骨囊肿缺损术后感染的可能原因,并提出预防及处理措施。方法 :对36例牙源性颌骨囊肿采用刮治术加医用硫酸钙骨粒植入治疗。患者术前均行颌骨曲面体层片(orthopantomography,OPT)或颌骨CT平扫加三维重建,明确囊肿位置和大小。采用颌骨囊肿刮治术加医用硫酸钙植入术进行治疗,术后观察并发症及成骨情况。结果:36例牙源性颌骨囊肿患者中,8例术后1周至1个月出现感染症状,主要表现为骨腔肿胀,疼痛,局部皮温升高,其中有2例伴有全身低热,给予抗感染处理,持续根管开放引流等措施后逐渐愈合。术后复诊成骨情况满意,但与术后未感染的骨腔相比,成骨时间延长。结论:医用硫酸钙植入颌骨囊肿术后应延长引流时间,加强抗感染处理,可有效减少感染的发生率。

PURPOSE： To analyze the possible causes of infection after operation and the usefulness of medical calcium sulfate bone particles in reconstruction of jaw cysts, and propose appropriate prevention and treatment measures. METHODS： Thirty-six cases of odontogenic cysts underwent curettage and calcium sulfate bone particle implantation. All patients were examined with orthopantomography （OPT） or CT scan and 3D reconstruction to determine the location and size of the cysts. The cysts were treated with curettage and medical calcium sulfate implantation. Postoperative complications and osteogenesis were observed. RESULTS： Eight out of 36 cases with odontogenic cysts had symptoms of infection 1 week to 1 month after surgery. The main manifestations were swelling, pain and increased skin temperature. Two cases had low fever, but recovered gradually with anti-inflamation and continuous root canal drainage. Osteogenesis was satisfactory after operation. CONCLUSIONS： It Prolonged drainage time and enhanced anti-infection treatment after jaw cyst curettage and medical calcium sulfate implantation can effectively reduce the incidence of postoperative infection.