低能量激光治疗对减轻唇腭裂患者牙槽突植骨术后软组织肿胀的疗效

Effects of low-level laser therapy on reduction of the soft tissue swelling in patients with cleft lip and palate after alveolar bone grafting

目的探讨低能量激光治疗对单侧完全性唇腭裂患者牙槽突植骨术后软组织肿胀的影响,为非介入性减轻患者术后肿胀提供新方法。方法选择2017年8月至2018年3月于北京大学口腔医学院·口腔医院颌面外科唇腭裂病区行牙槽突植骨术的单侧完全性唇腭裂患者33例,采用随机数表法将患者分为激光组(n=18)和对照组(n=15)。激光组术后第1天<24 h至第5天每天进行一次低能量激光治疗,共5次。每侧裂隙植骨区选择5个位点,每个位点2 min。对照组术后不采取低能量激光治疗。术前及植骨术后第1、3、5 d使用3DMD记录患者软组织三维肿胀程度变化。采用Geomagic Studio 2013及Geomagic Qualify 2013软件对患者软组织数字化三维摄影进行重叠测量,分析患者术后软组织肿胀情况。结果每个时间点激光组患者软组织肿胀程度较对照组均有减小,肿胀从术后第1天进行低能量激光治疗后即开始逐渐减小,而对照组患者从术后第1天至第3天肿胀程度逐渐增大,术后第3天肿胀程度达到最大值后开始消肿,2组消肿趋势不同。激光组与对照组在术后第3天肿胀程度有显著性差异[(0.674±0.174)VS.(1.430±0.485),P<0.05],而第5天2组的肿胀程度无统计学差异[(0.447±0.203)VS.(0.831±0.299),P>0.05]。结论低能量激光治疗可有效减轻唇腭裂患者牙槽突植骨术后软组织肿胀程度。

Objective To investigate the reduction effects of low-level laser therapy on soft tissue swelling in patients with unilateral complete cleft lip and palate after alveolar bone grafting, and to bring non-invasive treatment options. Methods Thirty-three unilateral cleft lip and palate inpatients who need alveolar bone grafting were included. The samples were divided into laser group (n=18) and control group (n=15) randomly. The patients in laser group were irradiated one time a day for 5 times in the grafting area immediately after surgery. Five sites were selected in each grafting area, and each site was irradiated for 2 minutes. The extent of soft tissue swelling before and at 1, 3, 5 days after surgery was recorded with 3D facial images by 3DMD, and the images were superimposed for further analysis by Geomagic Studio 2013 and Geomagic Qualify 2013 software. Results The extent of swelling was less in laser group than in control group at each time point. In laser group, the swelling was reducing as early as from day 1. In control group, the swelling increased from day 1 to day 3, and then start to reduce. There was significant difference in the third day after surgery between two groups [laser group (0.674±0.174) vs. control group (1.430±0.485), P<0.05]. In the fifth day after surgery, there was no significant difference [laser group (0.447±0.203) vs. control group (0.831±0.299), P>0.05]. Conclusions Low-level laser therapy can reduce the degree of the soft tissue swelling after alveolar bone grafting of patients with unilateral cleft lip and palate.