社会文化因素对牙颌面畸形患者选择正颌手术的影响

Influence of sociocultural factors on the selection of orthognathic surgery in patients with dental and maxillofacial deformities

目的:通过建立模型,探讨相貌社会文化因素对牙颌面畸形患者选择正颌手术的影响,以引导患者建立更加切合实际的治疗动机,提高治疗的配合度及满意度。方法:选择137例确诊为骨性错□畸形的正颌患者作为正颌组,另选择245名贵州某高校学生作为对照组,分别运用整形手术接受量表、正颌学相关生命质量问卷、对外貌的社会文化态度问卷等量表进行施测,问卷结果使用SPSS 24.0软件包进行分层回归分析。结果:模型拟合度良好(R^2=0.22),社会文化因素能显著预测牙颌面畸形患者对正颌手术的选择。正颌组中,上行社会比较有显著预测力(t=2.28,P<0.024);对照组中,上行社会比较(t=2.47,P<0.014)和外貌媒体压力(t=2.30,P<0.022)都有显著预测力。正颌相关社会压力能够显著解释正颌组整形手术的考虑(P<0.000),而对对照组解释力较弱(P<0.779)。结论:社会文化因素对牙颌面畸形患者选择正颌手术有着促进作用,同时也影响着患者对正颌手术结果的期待。

PURPOSE： To investigate social and cultural influence on preference of orthognathic surgery in patients with maxillofacial deformities through establishment of models, in order to provide motivational supports, improve treatment coordination and patients＇ satisfaction. METHODS： The orthognathic group included 137 patients with maxillofacial malformations, while the control group included 245 students from one university in Guizhou province. Acceptance of cosmetic surgery scale（ ACSS）, Orthognathic quality of life questionnaire（ OQLQ） and sociocultural attitudes towards appearance questionnaire-3（SATAQ-3） were used in two groups. SPSS 24.0 software package was used to analyze the data with hierarchical regression function. RESULTS： The results showed that there was a strong correlation between the studied variables（R^2=0.26）. Sociocultural factors could be used to predict patients＇ preference to orthognathic surgery.Patients in the orthognathic group could be predicted based on upward physical appearance comparison（ t=2.28, P〈0.024）,while subjects in the control group could be predicted based on upward physical appearance comparison（ t=2.47, P〈0.014）and the appearance media pressure（t =2.30, P〈0.022）. Orthognathic related social pressure significantly explained the considerations of plastic surgery in patients with dento-maxillofacial deformities（P〈0.000）; However, this factor had no significant explanation for the controls（P〈0.779）. CONCLUSIONS： Social and cultural factors are proven to contribute to the selection of orthognathic surgery for patients with dental and/or maxillofacial malformations, and may affect patients＇ expectation on the final results.