目的

研究在不进行局部麻醉清创的情况下采用碘仿碘甘油明胶海绵治疗干槽症的临床效果。

方法

纳入2020年7月至2023年7月于中山大学附属第三医院因干槽症就诊的患者32例，根据治疗方法将全部32例患者分为观察组和对照组，每组各16例。其中，观察组在不进行局部麻醉清创情况下，冲洗拔牙窝后填塞碘仿碘甘油明胶海绵，对照组按传统干槽症处理方法，局部麻醉下清创拔牙窝，3%过氧化氢水溶液、0.9%氯化钠溶液擦拭拔牙窝后填塞碘仿纱条。通过视觉模拟评分法（VAS）评估两组患者治疗后第1、3、7天的疼痛程度，检查第7天牙槽窝内肉芽组织生长、骨壁探痛情况，统计两组患者疼痛评分及治疗有效率，采用t 检验和卡方检验进行统计学分析。

结果

观察组患者在治疗前及治疗后第1、3、7天VAS评分分别为（8.50±0.89）、（7.19±0.98）、（3.44±1.15）和（1.13±0.74）分，相同时间点对照组VAS 评分分别为（8.44±0.96）、（6.69±1.20）、（3.16±0.81）和（1.06±0.83）分。与治疗前相比，两组患者治疗后第3天的VAS评分均出现明显下降，差异均有统计学意义（t _观察组=13.88，P _观察组＜0.001，t _对照组=16.91，P _对照组＜0.001）。两组在各个时间节点VAS评分相比差异均无统计学意义（t _治疗前=0.19，P _治疗前=0.85；t _治疗后3d=0.96，P _治疗后3d=0.35；t _治疗后7d=0.25，P _治疗后7d=0.80），观察组治疗有效率（93.75%）与对照组治疗有效率（100%）相比差异无统计学意义（χ²=1.032，P=0.31）。

结论

在不局部麻醉清创的情况下，采用碘仿碘甘油明胶海绵局部上药治疗干槽症可明显缓解患者疼痛症状，促进拔牙窝愈合，是有效、相对微创的治疗干槽症的方法。

Objective

To observe and evaluate the clinical effect of using iodoform-iodoglyceringelatin sponge to treat dry socket without local anesthetic debridement.

Methods

A total of 32 patients with dry socket who were treated at the Third Affiliated Hospital of Sun Yat-sen University from July 2020 to July 2023 were recruited，and they were divided into an observation group and a control group，with 16 patients in each. For the observation group，patients were treated without local anesthetic debridement，and the tooth socket was flushed and filled with iodoform-iodoglycerin-gelatin sponge. For the control group，the paitents were treated according to the traditional method of dry socket，where the tooth socket was debrided under local anesthesia，and the iodophor gauze was filled after hydrogen peroxide and saline cleaning.The pain degree（visual analogue scale）on the first，third，and seventh day after treatment，and the growth of granulation tissue in the tooth socket and the pain sensation of the bone wall on the seventh day were evaluated in the two groups. The pain score and treatment effectiveness of the two groups were statistically analyzed by t-test and Chi-square test，and the test level α = 0.05.

Results

For the observation group，the VAS pain scores before treatment，on the first，third，and seventh day after treatment were 8.50±0.89，7.19±0.98，3.44±1.15，and 1.13±0.74，respectively.For the control group，the VAS pain scores before treatment，on the first，third，and seventh day after treatment were 8.44±0.96，6.69±1.20，3.16±0.81，and 1.06±0.83，respectively.Compared with the first day，the VAS values of the observation and the control groups both showed significant decrease on the third days after treatment（t_{observationgroup} = 13.88，P_{observationgroup}＜0.001，t_controlgroup = 16.91，P_controlgroup＜0.001）. There was no statistical significance in pain scores between the two groups at each time point（t_0d=0.19，P_0d=0.85；t_3d=0.96，P_3d=0.35；t_7d=0.25，P_7d=0.80）.The treatment effective rate of the observation group（93.75%）and the control group（100%）showed no statistically significant difference（χ²=1.032，P=0.31）.

Conclusions

The use of iodoform-iodoglycerin-gelatin sponge for local treatment of dry socket could significantly relieve the pain symptoms of patients and promote the healing of the tooth socket，which would be an effective and relatively minimally invasive method for treating dry socket.