根管治疗术结合根尖刮治术治疗大范围根尖周病变的临床观察

Clinical observation on root canal therapy combined with apical curettage in the treatment of large periapical lesions

目的:对比分析根管治疗术联合根尖刮治术与单纯根管治疗术治疗大范围根尖周病的临床效果。方法:选取2020年1月~2022年11月期间收治的88例大范围根尖周病变患者为研究对象,按照治疗方式不同将患者分为对照组及观察组,每组各44例,对照组实施根管治疗术治疗,观察组实施根管治疗并根尖刮治术治疗,对比两组临床疗效、术后疼痛以及治疗前后龈沟液炎症因子水平,统计并发症发生情况。结果:随访1年,观察组临床总有效率(90.91%)高于对照组(70.45%)(P<0.05)。观察组术后疼痛感消失时间较对照组更短,术后24 h VAS评分较对照组更低(P<0.05)。治疗前,两组龈沟液IL-6、TNF-α、CRP水平对比未见明显差异(P>0.05),治疗后8周,两组上述炎症因子水平均下降,且观察组较对照组更低(P<0.05)。观察组并发症总发生率(22.73%)低于对照组(6.82%)(P<0.05)。结论:根管治疗联合根尖刮治术治疗大范围根尖周病变,疗效显著,可缓解疼痛,降低炎症因子水平及并发症发生率。

Objective:To comparatively analyze the clinical effects of root canal therapy combined with apical curettage versus simple root canal therapy in the treatment of large periapical lesions.Methods:A total of 88 patients with large periapical lesions treated in the hospital between January 2020 and November 2022 were selected as the study subjects.According to different treatment methods,the patients were divided into control group(44 cases,root canal therapy)and observation group(44 cases,root canal therapy combined with apical curettage).The clinical efficacy,postoperative pain and the levels of inflammatory factors were compared between groups.The incidence rates of complications were calculated.Results:One year of follow-up,the total clinical effective rate in the observation group(90.91%)was significantly higher than that in the control group(70.45%)(P<0.05).The time for postoperative pain disappearing in the observation group was shorter than that in the control group,and VAS score at 24 h after operation was lower than that of the control group(P<0.05).The levels of IL-6,TNF-αand CRP in gingival crevicular fluid of the two groups were comparable before treatment(P>0.05).Eight weeks after treatment,the levels of inflammatory factors mentioned above in both groups decreased,and the levels in the observation group were lower than those in the control group(P<0.05).The total incidence of complications in the observation group(22.73%)was significantly lower than that in the control group(6.82%)(P<0.05).Conclusion:Root canal therapy combined with apical curettage is significantly effective in the treatment of large periapical lesions,which can alleviate pain,lower the levels of inflammatory factors,and reduce the incidence of complications.