透明质酸钠与地塞米松磷酸钠治疗颞下颌关节紊乱病31例报告

Study on effect of sodium hyaluronate combined with sodium phosphate in treatment of tempormandibular joint internal derangement

目的观察透明质酸钠与地塞米松磷酸钠联合用药治疗颞下颌关节内紊乱病(TMJID)的疗效。方法2%利多卡因局麻下行颞下颌关节上腔穿刺,用生理盐水作关节上腔冲洗,吸干冲洗液后,同部位注入2ml:20mg的透明质酸钠lml和lml:5mg地塞米松磷酸钠0.5ml混合液,退出注射器。局部压迫数分钟,嘱患者做开闭口及侧向运动,使药物在关节腔内均匀分布。结果31例35侧1月后随访,显效10例(占32.26%),有效18例(占58.06%),无效3例(占9.68%),总有效率为90.32%,未见明显毒副作用。结论透明质酸钠与地塞米松磷酸钠联合用药治疗颞下颌关节内紊乱病具有缓解临床症状、改善关节功能的作用。

Objective To observe the therapeutic eccect of sodium hyaluronate(SH) combined with dexamethasone sodium phosphate intra-articular injections in treatment of tempormandibular joint internal derangement(TMJID). Methods After succeeding in acupuncture of the upper space of tempormandibular joint under 2%lidocaine hydrochloride injection local anaesthesia, 0.9%sodium chloride injection was applied to irrigate the upper joint space followed by being drained out. 1ml of 2ml 20mg SH and 0.5ml of 1ml:5mg dexamethasone sodium phosphate were injected into the injector was withdrawn. Pressed the injection area for several minutes then asked the patients to perform mandibular movement to distribute the medicines evenly inside the joint space. Results Thrity-one cases were followed up for 1 months.There were obvious improvements in the signs and function of TMJ in 10 patients(32.26%),only some improvements in 18 patients(58.06%),and no obvious improvements in other 3 patients(9.68%). The total effectual rate was 90.32%.No toxic or side effect was observed. Conclusion Sodium hyaluronate combined with dexamethasone sodium phosphate has a good therapeutic effect on relief of clinical symptoms and in improvement of articular function of TMJID.