天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
1期
78-80,81
,共4页
牙龈%磨牙,第三%拔牙%手术后并发症%切口%封套瓣%三角瓣
牙齦%磨牙,第三%拔牙%手術後併髮癥%切口%封套瓣%三角瓣
아간%마아,제삼%발아%수술후병발증%절구%봉투판%삼각판
gingiva%molar,third%tooth extraction%postoperative complications%incision%envelope flap%triangular flap
目的：评价2种不同牙龈翻瓣设计（封套瓣与三角瓣）对下颌第三磨牙拔除术后并发症的影响。方法采用随机、自身对照临床试验设计，选择就诊于天津医科大学口腔医院外科门诊患者52例，一侧采用封套式瓣，另一侧采用三角瓣设计拔除下颌第三磨牙。分别采用VAS评分评价术后疼痛，采用患者主观评价指标评价肿胀程度并测量上、下中切牙距离评价开口受限情况。记录患者术后第1、2、7天的肿胀、疼痛、开口受限情况和术后伤口裂开、出血、感染情况。对2种术式结果进行比较。结果术后第1、2、7天2种翻瓣设计对术后疼痛影响差异无统计学意义（P>0.05）。术后第1、2天三角瓣组面部肿胀较封套瓣组明显（Z分别为2.005、2.017，P<0.05）。术后第1、2天三角瓣组张口受限程度较封套瓣组明显（t分别为2.578、2.410，P<0.05），但第7天2组面部肿胀及开口度方面差异均无统计学意义（P>0.05）；2组术后疼痛、感染、出血及伤口裂开等不良反应发生率差异均无统计学意义（P>0.05）。结论封套瓣更有利于术后早期并发症控制，但两者远期预后并无明显差别。
目的：評價2種不同牙齦翻瓣設計（封套瓣與三角瓣）對下頜第三磨牙拔除術後併髮癥的影響。方法採用隨機、自身對照臨床試驗設計，選擇就診于天津醫科大學口腔醫院外科門診患者52例，一側採用封套式瓣，另一側採用三角瓣設計拔除下頜第三磨牙。分彆採用VAS評分評價術後疼痛，採用患者主觀評價指標評價腫脹程度併測量上、下中切牙距離評價開口受限情況。記錄患者術後第1、2、7天的腫脹、疼痛、開口受限情況和術後傷口裂開、齣血、感染情況。對2種術式結果進行比較。結果術後第1、2、7天2種翻瓣設計對術後疼痛影響差異無統計學意義（P>0.05）。術後第1、2天三角瓣組麵部腫脹較封套瓣組明顯（Z分彆為2.005、2.017，P<0.05）。術後第1、2天三角瓣組張口受限程度較封套瓣組明顯（t分彆為2.578、2.410，P<0.05），但第7天2組麵部腫脹及開口度方麵差異均無統計學意義（P>0.05）；2組術後疼痛、感染、齣血及傷口裂開等不良反應髮生率差異均無統計學意義（P>0.05）。結論封套瓣更有利于術後早期併髮癥控製，但兩者遠期預後併無明顯差彆。
목적：평개2충불동아간번판설계（봉투판여삼각판）대하합제삼마아발제술후병발증적영향。방법채용수궤、자신대조림상시험설계，선택취진우천진의과대학구강의원외과문진환자52례，일측채용봉투식판，령일측채용삼각판설계발제하합제삼마아。분별채용VAS평분평개술후동통，채용환자주관평개지표평개종창정도병측량상、하중절아거리평개개구수한정황。기록환자술후제1、2、7천적종창、동통、개구수한정황화술후상구렬개、출혈、감염정황。대2충술식결과진행비교。결과술후제1、2、7천2충번판설계대술후동통영향차이무통계학의의（P>0.05）。술후제1、2천삼각판조면부종창교봉투판조명현（Z분별위2.005、2.017，P<0.05）。술후제1、2천삼각판조장구수한정도교봉투판조명현（t분별위2.578、2.410，P<0.05），단제7천2조면부종창급개구도방면차이균무통계학의의（P>0.05）；2조술후동통、감염、출혈급상구렬개등불량반응발생솔차이균무통계학의의（P>0.05）。결론봉투판경유리우술후조기병발증공제，단량자원기예후병무명현차별。
Objective To evaluate effects of two different flap designs (envelope flap and triangular flap) on complica?tions after the mandibular third molar surgery. Methods A randomized, self controlled clinical trial design was selected for 52 patients treated in the outpatient surgery of Stomatological Hospital Affiliated to Tianjin Medical University. Patients were treated with envelope flap design for lower third molar removal in one side and triangular flap on the other side. VAS scores were used to evaluate postoperative pain. The postoperative swelling was evaluated by patient`subjective index. The degree of the upper and lower incisor distance was used to evaluate trismus. Data of postoperative swelling, pain and trismus were re?corded 1, 2 and 7 days after surgery. Data of postoperative wound dehiscence, bleeding situation and alveolitis were also re?corded and compared between two groups. Results There were no significant differences in postoperative pain after 1, 2 and 7 days between two flap designs (P>0.05). After 1 and 2 days there was more severe facial swelling in triangular flap group than that of envelope flap group (Z=2.005, Z=2.017, P<0.05). There was more limited mouth opening after 1 and 2 days in triangular flap group than that of envelope flap group (t=2.578, t=2.410, P<0.05), but on the seventh day there was no significant difference in the severity of facial swelling and trismus between two groups (P>0.05). There were no signifi?cant differences in postoperative pain, alveolitis, bleeding and wound dehiscence between two groups (P > 0.05). Conclu?sion The envelope flap is more conductive to the early recovery in patients after surgery, but in the long term there is no ob?vious difference between the two flap designs.
