改良开窗减压术治疗大型颌骨囊肿疗效分析  

Analysis of curative effect of the modified fenestration decompression treatment on large jaw cyst

作　　者：方鸿满 张冬玲[1] 邵建丽[2] 李铄希[2] 刘文书[2] 

机构地区：[1]武警吉林总队医院口腔科,吉林长春130052 [2]吉林大学第一医院,吉林长春130021

出　　处：《武警后勤学院学报（医学版）》2014年第12期1015-1016,1019,共3页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】评价患者配合程度对开窗减压术治疗大型颌骨囊肿的疗效影响。【方法】对在我院接受囊肿改良开窗减压术的45例颌骨囊肿患者（囊肿直径4.0-10.0 cm）于口腔内采用小切口或拔除囊肿区Ⅲ度松动牙作开窗,置固定引流管1根,视囊液流出的多少每日或隔日冲洗囊腔,并指导家属及患者如何进行冲洗操作。术后每1个月至1年内定期复诊,复查口腔全景片观察囊腔内颌骨骨质增生情况及观察囊腔内渗出物情况及囊肿腔大小的变化。【结果】45例患者中,定期复诊并坚持每日或及时冲洗,随诊1年后,无明显的继发感染症状,囊腔逐渐被新生骨完全替代者7例,占15.5%;囊腔由4.0-10.0 cm囊腔缩小至1.0-2.0 cm左右者35例,占77.8%;疗效显著为93.3%。3例囊腔4.0-6.0 cm左右的患者占6.7%,虽经过多次指导仍不能坚持执行冲洗操作,全景片显示囊腔减小不明显,并且仍有大量粘稠伴有脓液的囊液,实行了囊腔全刮治术。【结论】开窗减压术手术方法简单实用,并发症少;能最大限度保持颌骨的完整性,保护病变区的患牙,减少了患者的损伤和减轻了手术痛苦。但对患者配合度要求高,临床上患者不能认真很好的配合,会导致该方法的疗效的失败。[Objective] Evaluation of the influence of patients＇ compliance on curative effect of modified fenestration decompression treatment on large jaw cyst. [ Methods ]45 cases of jaw cysts （cyst diameter 4.0-10,0 cm） who were accepted modified cyst fenestration in our hospital, were taken a small incision in the oral cavity or removal of Ⅲ degree loose tooth at the cyst area for fenestration. Set a fixed drainage tube, rinse the cyst daily or every other day depending on the outflow of cyst fluid, and family members and patients were guided to perform flushing operations. After the surgery, the patients subsequently visited regularly every one month to one year. Oral panoramic radiograph were reviewed for observing hyperplasia of mandibular bone in cyst, exudate of cyst cavity and size of cysts. [ Re- sult] Among 45 cases of patients who re-visited regularly and kept flushing daily or in time, no obvious symptoms of secondary infection occurred, cystic cavity was completely replaced by new bone gradually in 7 cases which occupied 15.5%, cystic lumen shrink from 4.0-10.0 cm to 1.0-2.0 cm in 35 patients which occupied 77.8%. To sum up, the efficacy is 93.3%. 3 cases of patients whose cysts were around 4.0-6.0 cm didn＇t keep washing operation even received multiple instructions and accounted for 6.7%. No obvious shrink of cysts and lots of viscous liquid were showed on the panoramic film, and jaw cyst curettage was operated for the patient. [ Conclusion ] Fenestration decompression is a convenient and practical method with fewer complications; it can maximize maintain the integrity of the mandible, protect the teeth of lesion area, reduce trauma of patients and alleviate pain of surgery. However, fenestration decompression needs a good compliance of the patient, and it will lead to a failure if the patients cannot provide proper cooperation.

关 键 词：改良开窗减压术 颌骨囊肿 疗效 

分 类 号：R782[医药卫生—口腔医学]