开窗减压对颌骨牙源性囊性病变治疗作用研究  

Clinical Study of Odontogenic Cystic Lesions Treated by Fenestration and Decompression Technique

作　　者：胡方育[1] 李卓明[1] 胡传宇[2] 吴湘卿[2] 

机构地区：[1]四川省科学城医院口腔颌面外科,四川绵阳621900 [2]中南大学湘雅二医院口腔颌面外科,湖南长沙410005

出　　处：《现代生物医学进展》2010年第13期2490-2493,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨开窗减压对颌骨牙源性囊性病变的治疗作用。方法:102例牙源性颌骨囊性病变按囊肿大小分成两组,直径大于3.5cm且颌面部畸形明显的37例为甲组,全部采用开窗减压术;直径小于3.5cm的65例为乙组,其中27例(乙组A)采用开窗减压或开髓引流术,38例(乙组B)采用一次性手术切除。定期复查观察囊肿及颌骨变化情况,记录曲面断层片上囊腔影像面积变化,术后6月视情况采取II期手术治疗。结果:甲组开窗减压术后囊肿逐步缩小,骨质再生情况良好,颌面部外形改善,未出现神经及周围重要结构损伤症状,6月后囊肿面积平均缩小75.03%,与术前囊腔面积比较有显著差异(P<0.01),有效率100%,II期手术完成治疗;乙组A开窗减压或开髓引流组6月后有效率70.37%,大多采用二次手术治疗;乙组B一次手术切除治疗组囊腔愈合良好,6月后颌骨形态结构基本恢复正常,有效率100%,与乙组A有显著差异(P<0.05)。全部病例观察3至6年未见复发。结论:开窗减压术对大型颌骨囊性病变有很好的治疗作用;小型牙源性囊性病变最好选择一次性手术治疗。Objective：To study the therapeutical effect of fenestration and decompression technique in the treatment of odontogenic cystic lesions.Methods：102 patients were grouped into two groups according to the diameters of the capsular space：Group I（n = 37）,which diameters exceed 3.5cm,furthermore with conspicuous maxillofacial malformation adopted Fenestration and decompression technique;Group II（n=65）,which diameters were less than 3.5cm,of which 27 patients adopted decompression by fenestration or open pulp capping drainage（Group IIA）,the other 38 patients adopted disposable exairesis（Group IIB）.All patients needed to recheck the change of the cyst and bone regularly,recorded the change of capsular image areas on the contour slide plate.6 months later,according to the patient＇s condition,we made the decision of whether he（she） need II-stage operation.Results：After Fenestration and decompression,the size of the cysts reduced gradually.In group I,the jaw bones regenerated well,the forma of maxillofacial region was improved,aslo,there were no symptoms of nerves and periphery important structure detriment.6 months after operation,the area of cyst deflated 75.03% in average.There were significant deviation compared with preoperative capsular space（P〈0.01）.The effective power was 100%,complete healing after II-stage operation.6 months after operation,the effective power in group IIA was 70.37%,and most of them adopted II-stage operation.Capsular space in group IIB accreted well.Morphosis of jaw bones recuperated into normal essentially 6 months later,the effective power was 100%.There were significant deviation between group IIA and group IIB（P〈0.05）.No recurent case was observed in the next 3-6years.Conclusion：Fenestration and decompression technique is a safe,reliable,and effective procedure in the treatment of large jaw odontogenic cystic lesions;the best choice for small odontogenic cystic lesions is disposable exairesis.

关 键 词：牙源性囊性病变 开窗减压术 治疗作用 

分 类 号：R782[医药卫生—口腔医学]