不同手术方法治疗牙源性颌骨囊肿的疗效分析

Clinical evaluation of different surgical methods in treatment of odontogenic jaw cyst

目的分析开窗减压术、刮治术+引导骨再生技术(GBR)、单纯刮治术治疗牙源性颌骨囊肿的临床疗效。方法选择2016年8月至2017年8月于安徽医科大学第一附属医院住院治疗的牙源性颌骨囊肿患者60例为研究对象,经计算机随机分组结合患者意见将研究对象分为单纯刮治组(A组,28例)、刮治术+GBR组(B组,20例)、开窗减压组(C组,12例)。比较3组患者手术时间,术后并发症发生率,复发率及术后3、6、9、12个月囊肿体积缩小百分比。结果C组平均手术时间短于A、B两组,差异有统计学意义(P<0.05)。3组患者术后并发症发生率及术后6、12个月复发率比较,差异均无统计学意义(P>0.05)。术后3、6个月,B组平均囊肿体积缩小百分比明显大于A、C两组,差异有统计学意义(P<0.05);术后9、12个月,C组平均囊肿体积缩小百分比明显大于A、B两组,差异有统计学意义(P<0.05)。结论相较于单纯刮治术和刮治术+引导骨再生技术,开窗减压术是治疗牙源性颌骨囊肿的一种微创、安全且效果可靠的治疗方案。

Objective To analyze the clinical efficacy of fenestration decompression, curettage, guided bone regeneration (GBR), and simple curettage for odontogenic cysts. Methods Sixty patients with odontogenic jaw cysts who were hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University from Aug 2016 to Aug 2017 were selected as subjects. According to different surgical methods, the patients were divided into simple treatment group (group A, control group, 28 cases), curettage + GBR group (group B, 20 cases), and fenestration decompression group (group C, 12 cases). The average operation time, postoperative complication rate, recurrence rate and the percentage reduction of mean cyst volume 3, 6, 9 and 12 months after operation were compared and analyzed statistically. Results The average operation time was lower in group C than that in group A and B, and the difference was statistically significant ( P <0.05). There was no significant difference in postoperative complication rate and recurrence rate between 12 months and 6 months after operation among the three groups ( P >0.05). The percentage of average cyst shrinkage in group B was greater than that in group A and C in postoperative 3 and 6 months, and the difference was statistically significant ( P <0.05). The average cyst shrinkage percentage in group C was greater than that in group A and B in postoperative 9 and 12 months, and the difference was statistically significant (P <0.05). Conclusion Compared with simple curettage and scaling + guided bone regeneration (GBR), fenestration decompression is a minimally invasive, safe and effective treatment for odontogenic jaw cysts.