影像学移动度测量在颞下颌关节紊乱病诊断中的应用  

Application of moving degree measurement of imaging in diagnosis of temporomandibular disorders

作　　者：顾非[1] 庄月琴[1] 王峻良[1] 王炜[1] 周超[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中国医药导报》2016年第31期113-115,127,共4页China Medical Herald

基　　金：上海市科学技术委员会科研计划项目课题(12401906800)

摘　　要：目的探索新的影像学测量方法应用于颞下颌关节紊乱病临床诊断中的可行性及可靠性。方法采用流行病学中非全面调查中的典型调查,以颞下颌关节紊乱病常见发病年龄为基线,在上海中医药大学附属岳阳中西医结合医院张贴海报宣传,自愿入组的2013年9月~2014年12月期间无张口障碍、无颞颌关节疼痛及关节弹响等症状的在校大学生、研究生、公司员工、社区居民等正常人员300例。颞下颌关节紊乱病患者60例。拍摄标准颞下颌关节张闭口位片。测量张闭口位片中,外耳门前缘垂直切线到下颌骨髁顶点的垂直切线距离（A方法 ）和机械耳点垂直切线到下颌骨髁顶点的垂直切线距离（B方法 ）。用A、B两种方法测量张闭口位片中距离的差值——＂移动度＂,统计出正常人群95%可信区间下的颞下颌关节＂移动度＂参考范围。同样方法测量60例颞下颌关节紊乱病患者的颞下颌关节＂移动度＂,与正常人＂移动度＂比较,探讨该指标在颞下颌关节紊乱病临床诊断中的灵敏度。结果 300例正常人颞下颌关节移动度参考范围,A方法 ：左12.75~30.83 mm,右12.49~31.39 mm,应用于患者诊断的灵敏度为76.67%。B方法 ：左12.41~30.99 mm,右12.42~31.54 mm,应用于患者诊断的灵敏度为76.67%。A方法与B方法之间差异无统计学意义（P〉0.05）。结论颞下颌关节张闭口位X片关节移动度可应用于临床研究,且有一定的灵敏度。Objective To explore the feasibility and reliability of new imaging measuring method used in clinical diagnosis of temporomandibular disorders. Methods By using the typical investigation of non-overall investigation in epidemiology, taking the common onset age of temporomandibular disorders as basic line, the posters were displayed in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 300 normal persons, such as college students, graduate students, company staves, community residents, and so on, who had no mouth obstacles, pain and clicking of temporomandibular joint from September 2013 to December2014 were enrolled voluntarily. Temporomandibular disorders had 60 cases. The X-ray of temporomandibular disorders was taken in both open and closed mouth position. The vertical tangent distance between the leading edge of external acoustic meatus and the peak of mandibular condyle vertex was measured by method A. The vertical tangent distance between the mechanical porion and the peak of mandibular condyle vertex was measured by method B. The difference value of the distance ＂moving degree＂ was measured by the two methods, the reference range of the ＂moving degree＂of the temporomandibular joint under the 95% confidence interval in normal persons were statistically analyzed. The reference range of the ＂moving degree＂ of the temporomandibular joint in 60 cases with temporomandibular disorders was measured by the same method, and compared with the＂moving degree＂ of normal persons, so as to investigate the sensitivity of this index in clinical diagnosis of temporomandibular disorders. Results The reference range of the moving degree of temporomandibular joints in 300 normal persons： for A method, the reference range was 12.75-30.83 mm on the left and 12.49-31.39 mm on the right, the sensitivity for diagnosis was 76.67%; for B method, the reference range was 12.41-30.99 mm on the left and12.42-31.54 mm on the right, the sensitivity

关 键 词：颞下颌关节紊乱病 诊断 影像学 移动度 

分 类 号：R782.6[医药卫生—口腔医学]