骨移植修复术治疗下颌骨节段性缺损的安全性及疗效分析  

Analysis on the Safety and Efficacy of Bone Grafting and Repairing in the Treatment for Mandibular Segmental Defects

作　　者：崔延军[1] 王红光[1] 程汇 

机构地区：[1]天门市第一人民医院口腔科,湖北天门431700

出　　处：《医学综述》2014年第23期4416-4416,F0003,共2页Medical Recapitulate

摘　　要：目的观察骨移植修复术治疗下颌骨节段性缺损(MSD)的疗效,以探讨骨移植修复术的安全性及有效性。方法选取2011年3月至2013年3月于天门市第一人民医院就诊的MSD患者82例,采用随机数字表法分为两组:观察组41例采用游离髂骨修复术,对照组41例采用单纯重建钛板修复术。术后1年,分析比较两组患者面部外形、咬合关系、颞颌关节功能、开口度以及并发症的发生情况。结果观察组颞颌关节功能显著优于对照组,差异有统计学意义(P<0.05);观察组面部外形、咬合关系、开口度均优于对照组,但差异无统计学意义(P>0.05)。观察组切口感染发生率显著低于对照组(P<0.05);观察组钛钉松动、钛板折断、钛板外露、颌面部瘘口的发生率均低于对照组,但差异无统计学意义(P>0.05)。结论游离髂骨修复术对于恢复下颌骨及口腔功能具有重要意义,且并发症发生率较单纯重建钛板修复术低,是一种安全有效的修复方式,值得临床借鉴。Objective To observe the efficacy of bone grafting and repairing in the treatment for mandibular segmental defects（ MSD）, and to investigate the safety and effectiveness of bone grafting and repairing. Methods A total of 82 cases of patients with segmental mandibular defects admitted in the First People＇s Hospital of Tianmen City from Mar. 2011 to Mar. 2013 were randomly divided into the observation group （41 cases） and the control group（41 cases） by the random number table. Patients in the observation group received the treatment of free ilia,c bone grafting and repairing,while patients in the control group received the treatment of simple titanium plate repairing. One year later after the surgery, the facial shape, occlusal relationships, temporomandibular joint function, mouth opening degree and the occurrence of complications were compared between the two groups. Results Temporomandibular joint function of the observation group was better than the control group, and the difference was statistically significant （ P 〈 0.05 ） ; facial appearance, occlusal relationships,opening degree of the observation group were better than the control group, but the differences were nut statistically significant （ P 〉 0.05 ）. The wound infection rate of the observation group was significantly lower than the control group （P 〈 0.05 ） ;the incidence rates of titanium.screw loose,titanium plate break, titanium plate exposure, maxillofacial fistula of the observation group were lower than the con- trol group, but the differences were not statistically significant （ P 〉 0.05 ）. Conclusion Free iliac bone grafting and repairing is important for the restoration of the mandible and oral function, and the incidence of complications is lower than the simple titanium plate repairing, thus, it is a safe and effective way of bone repairing, and is worthy of clinical reference.

关 键 词：下颌骨缺损 游离髂骨修复术 重建钛板修复术 安全性 有效性 

分 类 号：R783[医药卫生—口腔医学]