开窗减压术与颌骨囊肿刮治术治疗颌骨囊肿的疗效比较及对术后血清疼痛介质的影响

Comparison between Fenestration Decompression and Curettage of Jaw Cyst in the Treatment of Jaw Cyst and its Eeffect on Postoperative Serum Pain Mediators

目的:对比开窗减压术与颌骨囊肿刮治术治疗颌骨囊肿的疗效及术后血清疼痛介质变化。方法:回顾性分析2016年1月-2019年8月期间我院收治的60例颌骨囊肿患者的临床资料。按治疗方式的区别分为A组(颌骨囊肿刮治术,28例)和B组(开窗减压术,32例),观察两组手术指标情况、术后恢复指标、并发症及术后血清疼痛介质变化。结果:与A组相比,B组的术中出血量更少,手术时间更短,术后疼痛评分更低,组间对比差异有统计学意义(P<0.05)。与A组相比,B组的骨密度水平更高,骨质增生厚度更厚,囊腔体积缩小率更大,囊肿愈合时间更短,组间对比差异有统计学意义(P<0.05)。B组术后2 h、术后12 h血清神经肽Y(NPY)、P物质(SP)、神经生长因子(NGF)水平低于A组,β内啡肽(β-EP)水平高于A组(P<0.05)。两组并发症发生率组间对比无统计学差异(P>0.05)。结论:与颌骨囊肿刮治术治疗颌骨囊肿相比,开窗减压术在减少术中出血量、缩短手术时间、降低患者术后疼痛、促进患者术后恢复方面优势更为显著。

Objective: To compare the efficacy of fenestration decompression and curettage of jaw cyst in the treatment of jaw cyst and the changes of serum pain mediators after operation. Methods: The clinical data of 60 patients with jaw cyst who were treated in our hospital from January 2016 to August 2019 were analyzed retrospectively. According to the difference of treatment methods, they were divided into group A(curettage of jaw cyst, 28 cases) and group B(fenestration decompression, 32 cases). The operation indexes, postoperative recovery indexes, complications and changes of serum pain mediators in the two groups were observed. Results: Compared with group A, group B had less intraoperative bleeding, shorter operation time and less postoperative pain score. There was significant difference between groups(P<0.05). Compared with group A, group B had higher bone mineral density, thicker hyperosteogeny, larger reduction rate of cyst volume and shorter cyst healing time. There was significant difference between groups(P<0.05). The levels of serum neuropeptide Y(NPY), substance P(SP) and nerve growth factor(NGF) in group B were lower than those in group A at 2 h and 12 h after operation, β Endorphins(β-EP) was higher than that in group A(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion: Compared with curettage for jaw cyst, fenestration decompression has significant advantages, which can reduce intraoperative bleeding, shorten operation time, reduce postoperative pain and promote postoperative recovery.