下颌升支矢状截骨术后肌功能康复训练的临床探讨  

Clinical study of muscular rehabilitation after sagittal split ramus osteotomy

作　　者：杨学文[1] 龙星[1] 东耀峻[1] 陈红生[2] 孙绍山[2] 

机构地区：[1]武汉大学口腔医学院口腔颌面外科,430079 [2]口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室

出　　处：《中华口腔医学杂志》2010年第8期487-489,共3页Chinese Journal of Stomatology

摘　　要：目的 探讨肌功能康复训练对下颌升支矢状截骨术后功能恢复的作用.方法 利用自行研制的张口训练器,借鉴国外的功能训练方法 ,对接受下颌升支矢状截骨术的27例患者进行被动张口训练和有阻力的肌肉耐力训练,在颌间牵引拆除后2～3 d,使用张口训练器插入牙列间锻炼张口度,5 min/次,3～4次/d.在张口度达到20～25 mm后进行肌肉耐力训练.患者用后牙咬合施加阻力后的张口器并维持5 s后,松弛5 s再咬合,反复进行,5 min/次,3～4次/d,持续3～4周.27例康复训练结果 与20例接受同类手术未行功能康复训练的患者对比.结果 接受肌功能训练的患者术后4周时张口度[（34.72±3.75）mm]已接近术前水平,8周时（牙合）力[（231.08±62.52）N]达到术前水平.未接受肌功能训练的患者在术后4、8周时张口度[（28.42±4.11）mm]和（牙合）力[（210.90±73.40）N]均值仍低于术前,差异有统计学意义（P＜0.05）.结论 系统和规范的肌功能康复训练,并配合使用新型张口训练器,能加速下颌升支矢状截骨术患者口颌系统功能的恢复速度.Objective To investigate the effect of muscular rehabilitation on recovery after sagittal split ramus osteotomy. Methods Twenty-seven patients undergoing sagittal split ramus osteotomy received passive motion training and muscle endurance training after surgery using the new-developed mouth-opening trainer. The passive motion training began 2-3 days after the removal of inter-maxillary elastraction. The instrument was inserted into the inter-maxillary space for 5 min per time, 3-4 times per day. When the mouth opening reached a range of 20-25 mm, the muscle endurance training initiated. The results of the training were compared with another 20 cases who received the same surgery. Results The mouth opening of the patients who received muscular rehabilitation achieved the pre-surgical level 4 weeks after surgery [（34. 72 ±3. 75） mm], the bite force reached the pre-surgical level 8 weeks after surgery [ （231.08 ±62. 52） N], but in the 20 cases without training the mouth opening [ （28. 42 ±4. 11 ） mm] in 4 weeks and the bite force in 8 weeks [ （210. 90 4±73.40） N] were lower after surgery than before surgery. Conclusions The systematic and standard muscle function training, accompanied with the use of the new-developed mouth-opening trainer could improve the functional recovery of the patients who receive sagittal split ramus osteotomies.

关 键 词：功能恢复 肌功能疗法 张口度 

分 类 号：R782.2[医药卫生—口腔医学]