中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
7期
695-699
,共5页
彭国光%杨磊%王科%谭玉莲
彭國光%楊磊%王科%譚玉蓮
팽국광%양뢰%왕과%담옥련
骨折%下颌骨髁状突%口腔外科手术
骨摺%下頜骨髁狀突%口腔外科手術
골절%하합골과상돌%구강외과수술
Fracture bone%Mandibular condyle%Oral surgical procedures
目的 研制一种适合髁突矢状骨折(sagittal fracture of mandibular condyle,SFMC)骨碎块复位和内固定的复位钳,并评价其临床应用效果. 方法 对20例三维CT确诊的下颌骨SFMC患者行开放性手术治疗.按随机数字表法分为试验组和对照组,每组10例.试验组用研发的髁突复位钳进行手术复位和内固定;对照组用经典血管钳和神经拉钩行复位内固定手术.分别记录两组患者的手术时间、术前和术后2周三维CT、术前和术后1,6个月咬合情况、最大开口度(maximal mouth opening,MMO)、视觉模拟评分(visual analogue scale,VAS)、关节弹响和杂音.结果 试验组和对照组术时间分别为(0.90 ±0.11)h、(1.34±0.1O)h,试验组手术时间明显缩短(t=-10.8,P＜0.01).试验组和对照组术后1,6个月MMO分别为[(32.6±1.6)mm∶ (29.7±1.6) mm]和[(34.3±1.2)mm∶(33.3±1.1)mm](t=-10.1,3.4,P＜0.01);试验组和对照组术后1,6个月VAS分别为[(3.6±0.7)∶(5.1±0.7)]和[(3.5±0.9)∶(4.8±0.6)](t=-12.5,-3.3,P＜0.01),试验组术后MMO和VAS明显改善. 结论 髁突复位钳可明显缩短SFMC的手术时间,改善开口功能和缓解疼痛.
目的 研製一種適閤髁突矢狀骨摺(sagittal fracture of mandibular condyle,SFMC)骨碎塊複位和內固定的複位鉗,併評價其臨床應用效果. 方法 對20例三維CT確診的下頜骨SFMC患者行開放性手術治療.按隨機數字錶法分為試驗組和對照組,每組10例.試驗組用研髮的髁突複位鉗進行手術複位和內固定;對照組用經典血管鉗和神經拉鉤行複位內固定手術.分彆記錄兩組患者的手術時間、術前和術後2週三維CT、術前和術後1,6箇月咬閤情況、最大開口度(maximal mouth opening,MMO)、視覺模擬評分(visual analogue scale,VAS)、關節彈響和雜音.結果 試驗組和對照組術時間分彆為(0.90 ±0.11)h、(1.34±0.1O)h,試驗組手術時間明顯縮短(t=-10.8,P＜0.01).試驗組和對照組術後1,6箇月MMO分彆為[(32.6±1.6)mm∶ (29.7±1.6) mm]和[(34.3±1.2)mm∶(33.3±1.1)mm](t=-10.1,3.4,P＜0.01);試驗組和對照組術後1,6箇月VAS分彆為[(3.6±0.7)∶(5.1±0.7)]和[(3.5±0.9)∶(4.8±0.6)](t=-12.5,-3.3,P＜0.01),試驗組術後MMO和VAS明顯改善. 結論 髁突複位鉗可明顯縮短SFMC的手術時間,改善開口功能和緩解疼痛.
목적 연제일충괄합과돌시상골절(sagittal fracture of mandibular condyle,SFMC)골쇄괴복위화내고정적복위겸,병평개기림상응용효과. 방법 대20례삼유CT학진적하합골SFMC환자행개방성수술치료.안수궤수자표법분위시험조화대조조,매조10례.시험조용연발적과돌복위겸진행수술복위화내고정;대조조용경전혈관겸화신경랍구행복위내고정수술.분별기록량조환자적수술시간、술전화술후2주삼유CT、술전화술후1,6개월교합정황、최대개구도(maximal mouth opening,MMO)、시각모의평분(visual analogue scale,VAS)、관절탄향화잡음.결과 시험조화대조조술시간분별위(0.90 ±0.11)h、(1.34±0.1O)h,시험조수술시간명현축단(t=-10.8,P＜0.01).시험조화대조조술후1,6개월MMO분별위[(32.6±1.6)mm∶ (29.7±1.6) mm]화[(34.3±1.2)mm∶(33.3±1.1)mm](t=-10.1,3.4,P＜0.01);시험조화대조조술후1,6개월VAS분별위[(3.6±0.7)∶(5.1±0.7)]화[(3.5±0.9)∶(4.8±0.6)](t=-12.5,-3.3,P＜0.01),시험조술후MMO화VAS명현개선. 결론 과돌복위겸가명현축단SFMC적수술시간,개선개구공능화완해동통.
Objective To develop a suitable forcep for reduction and internal fixation of sagittal fracture of mandibular condyle (SFMC) and evaluate its role in clinical practice.Methods Twenty patients with SFMC diagnosed by three-dimensional CT undergone open surgery were divided into experimental group and control group with 10 patients per group,according to the random number table.Patients in experimental group were reduced and fixed using the new reduction forcep,while in control group by the classical vascular clamp and nerve retractor.Operation time,three-dimensional CT before operation and 2 weeks after operation,and occlusion,maximum mouth opening (MMO),visual analogue scale (VAS),joint clicking as well as noise before operation and 1 and 6 months after operation were recorded.Results Operation time was obviously lower in experimental group than in control group [(0.90 ± O.11)hours vs (1.34 ±0.10)hours,t =-10.8,P ＜0.01].MMO in experimental group revealed significant improvements compared to control group at postoperative 1 month [(32.6 ± 1.6) mm vs (29.7 ±1.6)mm,t =-10.1,P＜0.01] and at postoperative 6 months [(34.3 ± 1.2)mm vs (33.3 ± 1.1)mm,t =3.4,P ＜0.01].VAS between experimental group and control group also differed significantly at postoperative 1 month [(3.6 ± 0.7) mm vs (5.1 ± 0.7) mm,t =-12.5,P ＜ 0.01] and at 6 months [(3.5±0.9) points vs (4.8±0.6) points,t=-3.3,P＜0.01].Conclusion The new reduction forcep can shorten operative time and improve mouth opening and pai for SFMC.
