甲钴胺对拔牙引起下牙槽神经血管束损伤后相关症状的预防效果观察  

Mecobalamin was preventively used for controlling nerve injury after the removal of mandibular third molars close to the inferior alveolar canal

作　　者：项欢[1] 陆钰[2] 沈洋[2] 吴海珍[1,2] 

机构地区：[1]安徽医科大学解放军临床学院,安徽合肥230032 [2]中国人民解放军第一零五医院口腔中心,安徽合肥230031

出　　处：《安徽医药》2017年第7期1322-1324,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评估术前拍摄锥形束CT(CBCT)及预防性服用甲钴胺对下颌阻生智齿拔除引起下牙槽神经血管束损伤后出现下唇麻木症状的控制效果。方法 90例拔除与下颌神经管关系密切的阻生智齿的病人采用随机数字表法分为观察组及对照组,每组45例。观察组术前60 min给予甲钴胺片(连续口服,1周内若未出现神经症状则停用)+术后常规消炎止痛治疗,对照组仅术后常规消炎止痛治疗,待病人出现下唇麻木症状时才给予营养神经的药物。采用病人主诉下唇麻木症状和两点辨别觉的方法评估两组病人出现术后神经损伤的情况,并追踪这些症状的恢复情况。结果观察组与对照组术后出现下唇麻木症状的例数相比,差异有统计学意义(P<0.05)。出现下唇麻木并服用营养神经药物后,所有病人均于术后6个月内恢复。结论对CBCT显示与下颌神经管关系密切的阻生智齿拔除的病人预防性给予营养神经药物可以减少术后口唇麻木的发生,促进损伤神经的恢复。Objective To evaluate the effect of preoperatively photographed cone beam computed tomography （CBCT） and preventively used neurotrophic medicine Mecobalamin on controlling lip numbness symptoms when the mandibular nerval tube was injured after the removal of mandibular third molars close to the inferior alveolar canal （IAC）.Methods Ninety patients who required to extract mandibular third molars close to the IAC were randomly assigned into treatment group and control group,45 per group.Mecobalamin tablets were given to those in treatment group 1 hour before the operation （continuously given until no nerve numbness symptoms for 1 week） plus conventionally used anti-inflammatory and analgesic medicine after operation.The control group was only given conventional anti-inflammatory and analgesic treatment,and neurotrophic medicine was not given until the patient said that he felt lip numbness.The methods of patients describing their feelings and two-point discrimination were adopted to evaluate symptoms of lip numbness and nerve injury in patients of both groups,and the relief of those symtoms were followed.Results There was statistically significant difference in lip numbness between the two groups （P〈0.05）.All the patients who got the symptom of lip numbness recovered in 6 months after being given neurotrophic medicine.Conclusions Preventively using neurotrophic medicine can reduce the number of patients′ lip numbness symptoms after the removal of mandibular third molars close to the IAC showed by CBCT,and promote the recovery of nerve injury.

关 键 词：下颌阻生智齿 下颌神经管 营养神经 

分 类 号：R782.11[医药卫生—口腔医学]