切换至 "中华医学电子期刊资源库"

中华口腔医学研究杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 89 -93. doi: 10.3877/cma.j.issn.1674-1366.2022.02.004

论著

囊腔冲洗对颌骨囊性病变开窗减压术疗效的影响
李芸1, 游云华2,()   
  1. 1. 中山大学附属第五医院健康管理中心,珠海 519000
    2. 中山大学附属第五医院口腔科,珠海 519000
  • 收稿日期:2021-12-16 出版日期:2022-04-01
  • 通信作者: 游云华

Evaluation of the effect of capsule irrigation on marsupialization of jaw cystic lesions

Yun Li1, Yunhua You2,()   

  1. 1. Health Management Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
    2. Department of Stomatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
  • Received:2021-12-16 Published:2022-04-01
  • Corresponding author: Yunhua You
引用本文:

李芸, 游云华. 囊腔冲洗对颌骨囊性病变开窗减压术疗效的影响[J/OL]. 中华口腔医学研究杂志(电子版), 2022, 16(02): 89-93.

Yun Li, Yunhua You. Evaluation of the effect of capsule irrigation on marsupialization of jaw cystic lesions[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2022, 16(02): 89-93.

目的

探讨颌骨囊性病变开窗减压术后囊腔冲洗效率与疗效的关系。

方法

回顾性分析2013年6月至2021年6月中山大学附属第五医院口腔颌面外科收治的颌骨囊性病变开窗术患者41例,其中男28例、女13例,年龄6 ~ 67岁,平均27.5岁;根据颌骨囊性病变大小、位置及深浅不同,术后囊腔冲洗方式分为脉冲式组(26例)和泵压式组(15例);根据患者依从性差异导致每天冲洗次数不同分为:A组(18例),囊腔冲洗≤2次/d;B组(23例),囊腔冲洗≥3次/d。每2个月拍摄全颌曲面断层片,比较两组术后囊肿缩小情况。囊肿体积缩小率≥50%为显效,囊肿体积缩小率<50%为好转,囊肿无变化或增大为复发。对术后两组囊腔冲洗方式和每天冲洗次数的疗效进行统计学分析。采用SPSS 13.0软件包对数据进χ2检验。

结果

41例患者中,脉冲式组术后有效率为53.8%;其中3例因囊腔深、不规则、囊腔间隔通畅性差,开窗术后囊肿体积增大;泵压式组(15例)术后有效率为60.0%;两组比较差异无统计学意义(χ2 = 1.876,P>0.05);A组术后有效率为38.9%,B组为69.6%,两组比较差异有统计学意义(χ2 = 3.864,P<0.05)。

结论

囊腔冲洗方式对开窗减压术后疗效无明显影响;囊腔冲洗≥3次/d及多方位彻底冲洗可提高开窗减压术后疗效,加快囊肿恢复。

Objective

To investigate the relationship between capsule irrigation and curative effect after marsupialization for cystic lesions of jaw.

Methods

Among the patients admitted to oral and maxillofacial surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from June 2013 to June 2021, 41 patients with giant jaw cystic lesions (28 males and 13 females) were selected. The patients were aged from 6 to 67 years old, with an average of 27.5 years. According to the size, location and depth of jaw cystic lesions, the methods of postoperative capsule irrigation were divided into pulse group (26 cases) and pump pressure group (15 cases) . According to patient compliance, the patients were divided into two groups: Group A (18 cases) , cystic flushing <2 times/d; Group B (23 cases) , cystic flushing ≥3 times/d. The full jaw surface tomography was taken every 2 months to compare the reduction of cyst between the two groups. The evaluation criteria were set as follows: the reduction rate of cyst volume ≥50%: effective; the reduction rate of cyst volume <50%: improved; the cyst had no change or enlargement: recurrence. The curative effects of the two groups on the way of capsule irrigation and the times of irrigation every day were statistically analyzed by using SPSS 13. 0 with χ2 test.

Results

Among the 41 patients, the efficiency of postoperative cyst reduction in the pulse group (26 cases) was 53.8%, of which 3 cases had increased volume of cysts after marsupialization due to the depth, irregularity and poor cystic septal opening. The pump pressure group (15 cases) had an effective rate of postoperative cyst reduction of 60.0%, and there was no significant difference in the efficiency of cyst volume reduction between the two groups (χ2 = 1.876, P>0.05) . Group A (18 cases) had an effective rate of postoperative cyst volume reduction of 38.9%, whereas the rate for group B (23 cases) was 69.6%, and the difference in the efficiency of cyst volume reduction in the two groups was statistically significant (χ2 = 3.864, P<0.05) .

Conclusions

There was no effect of flushing methods on the clinical efficacy of capsule irrigation on the marsupialization of cystoid disease of the jaw. Capsule irrigation with ≥3 times/d significantly improved its efficacy on the marsupialization of cystoid disease of the jaw.

图1 脉冲式囊腔冲洗器 A:冲牙器;B:调整囊腔冲洗压力;C:患者自行囊腔冲洗。
图2 泵压式囊腔冲洗器 A:蠕动泵;B:硅胶软管;C:患者自行囊腔冲洗。
表1 41例颌骨囊性病变开窗减压术后囊腔冲洗方式与疗效的关系
表2 41例颌骨囊性病变开窗减压术后每天冲洗次数与疗效的关系
图3 囊肿开窗减压术后囊腔缩小骨形成过程 A:开窗术前;B:术后2个月;C:术后6个月;D:术后10个月;E:术后14个月;F:术后18个月。
图4 囊肿开窗减压术前、术后颌骨囊性病变患者X线影像 A:术前锥形束CT(CBCT)矢状面;B:术前CBCT冠状面;C:术后6个月CBCT;D:术后6个月全颌曲面断层片。
[1]
李芸,游云华,梁军,等.保留下颌骨连续性的成釉细胞瘤刮治术临床应用[J/CD].中华临床医师杂志(电子版)20104(12):2559-2562. DOI:10.3877/cma.j.issn.1674-0785.2010.12.041.
[2]
李芸,游云华,梁立中.颌骨囊性病变开窗减压术及义齿式囊肿塞的应用与疗效观察[J/OL].中华口腔医学研究杂志(电子版)201610(3):193-197. DOI:10.3877/cma.j.issn.1674-1366.2016.03.008.
[3]
熊依箐,曹志云,李罡,等.颌骨囊肿开窗减压术后戴塞治器疗效分析[J].口腔医学201837(7):630-633+644. DOI:10.13591/j.cnki.kqyx.2018.07.012.
[4]
高丽梅,刘璐,崔麦芹,等.开窗减压术联合囊肿塞治疗青少年大型下颌骨囊肿的临床研究[J].现代口腔医学杂志202135(1):23-25. DOI:10.13591/j.cnki.kqyx.2018.07.012.
[5]
冯大军,蒋勇,孙云峰,等.个体化阻塞器在颌骨囊肿开窗减压术后的应用[J].现代口腔医学杂志202034(6):373-374.
[6]
李玉宝.开窗减压术联合囊肿塞在颌骨囊肿治疗中的应用研究[J].基层医学论坛202125(5):663-664. DOI:10.19435/j.1672-1721.2021.05.036.
[7]
杜悦,彭笑,韩瑞,等.颌骨囊肿开窗治疗临床特征动态研究[J].上海口腔医学202130(6):658-662. DOI:10.19439/j.sjos.2021.06.019.
[8]
Wang LMa CLi X,et al. Comparison of wall removal type versus wall retaining type of decompression for treating large mandibular odontogenic cysts[J]. Oral Dis202026(2):350-359. DOI:10.1111/odi.13233.
[9]
武志强,费洪静,王秋旭,等.应用开窗减压术和2种阻塞器治疗大型颌骨囊性病变的临床效果[J].中国医科大学学报201746(11):1048-1051. DOI:10.12007/j.issn.0258-4646.2017.11.021.
[1] 张启龙, 柳亿, 卢会丽, 罗慧, 李成林, 王菁, 王辉. 奥妥珠单抗治疗磷脂酶A2受体相关膜性肾病的疗效与安全性:单中心回顾性分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 379-384.
[2] 王杰, 袁泉, 王玥琦, 乔佳君, 谭春丽, 夏仲元, 刘守尧. 溃疡油在糖尿病足溃疡治疗中的应用效果及安全性观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 480-484.
[3] 聂生军, 王钰, 王毅, 鲜小庆, 马生成. 复方倍他米松局部注射联合光动力疗法治疗小型瘢痕疙瘩的临床疗效观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 404-410.
[4] 莫淇舟, 苏劲, 黄健, 李健维, 李思宁, 柳建军. 智能控压输尿管软镜碎石吸引取石术在直径10~25 mm上尿路结石中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 497-502.
[5] 李义亮, 苏拉依曼·牙库甫, 麦麦提艾力·麦麦提明, 克力木·阿不都热依木. 机器人与腹腔镜食管裂孔疝修补术联合Nissen 胃底折叠术短期疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 512-517.
[6] 周艳, 李盈, 周小兵, 程发辉, 何恒正. 不同类型补片联合Nissen 胃底折叠术修补食管裂孔疝的疗效及复发潜在危险因素[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 528-533.
[7] 王小琴, 汪丽, 崔建英. 无张力疝修补术治疗慢性肾功能衰竭合并腹股沟疝患者的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 538-542.
[8] 王亚岚, 倪婧, 余世庆, 陶银花, 张荣. 尼达尼布抗纤维化治疗特发性肺纤维化的耐受性和疗效预测因素分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 750-755.
[9] 詹济玮, 蔡柳春, 温琼娜, 郭石生, 温春妹, 温鹤明. 布地格福联合噻托溴铵治疗AECOPD 的临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 823-826.
[10] 魏孔源, 仵正, 王铮, 黎韡. 机器人胰腺中段切除后远端胰腺消化道不同重建方式初探[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 295-300.
[11] 陈杰, 武明胜, 李一金, 李虎, 向源楚, 荣新奇, 彭健. 低位直肠癌冷冻治疗临床初步分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 494-498.
[12] 史彬, 司远. 益气和络方联合缬沙坦治疗气阴两虚兼血瘀证IgA 肾病的疗效观察[J/OL]. 中华肾病研究电子杂志, 2024, 13(06): 306-312.
[13] 韩俊岭, 王刚, 马厉英, 连颖, 徐慧. 维生素D 联合匹维溴铵治疗腹泻型肠易激综合征患者疗效及对肠道屏障功能指标的影响研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 560-564.
[14] 阳跃, 庹晓晔, 崔子豪, 欧阳四民, 林海阳, 胡景宇, 胡银, 李涛, 赵景峰, 郝岱峰, 冯光. 改良“阅读者”皮瓣修复骶尾部压疮的疗效[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 751-755.
[15] 克地尔牙·马合木提, 胡波, 杨琼, 闫素, 胡岚卿, 高沛沛, 姚恩生. 依达拉奉右莰醇对急性脑梗死后认知功能障碍的疗效观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 459-466.
阅读次数
全文


摘要