颞下颌关节镜治疗关节盘前移伴穿孔患者的全程康复护理探讨  

Full-time rehabilitation nursing in arthroscopic discopexy for anterior disc displacement with perforation of temporomandibular joint

作　　者：恽白[1] 俞蕾蕾[1] 罗怡[1] YUN Bai;YU Lei-lei;LUO Yi(Department of Nursing,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院护理部,上海200011

出　　处：《中国口腔颌面外科杂志》2020年第6期531-534,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市卫生和计划生育委员会科研课题(201740277);上海交通大学医学院附属第九人民医院护理院基金(JYHL20193D02)。

摘　　要：目的:探讨颞下颌关节镜下盘复位手术对治疗关节盘前移伴穿孔患者全程康复护理的应用效果。方法:回顾分析2017年1月—2018年12月间因颞下颌关节盘前移伴穿孔而接受颞下颌关节镜下盘复位治疗的54例患者,配合实施全程康复护理干预。比较治疗前、后的疼痛视觉模拟量表(VAS)和最大开口度(MIO),以及术后生活质量评分指标。评价全程康复护理配合关节镜治疗的疗效。采用SPSS 24.0软件包对数据进行统计学处理。结果:所有患者全程配合度好、依从性好,均能定期复诊,无失访病例,并按规定完成术后开口训练及牙合垫配戴。术后6个月随访显示,MIO平均值由术前的(31.76±7.40)mm增至(35.24±6.22)mm(P=0.001);VAS平均得分由术前的(3.13±2.76)分降至(0.96±1.26)分(P=0.04)。治疗后生活质量评分指标的平均得分为42.11±2.21,患者满意度为90%(≥40)。结论:全程康复护理通过对患者进行术前、术中、术后一体化、个体化优质护理,有助于提高颞下颌关节镜下盘复位手术对关节盘前移伴穿孔的治疗效果,改善开口功能,缓解疼痛。PURPOSE:To introduce and evaluate the effect of full-time rehabilitation nursing in arthroscopic discopexy for patients of anterior disc displacement with perforation in temporomandibular joint(TMJ).METHODS:A retrospective study from January 2017 to December 2018 was made on patients(anterior disc displacement with perforation)who were treated by arthroscopic discopexy combined with full-time rehabilitation nursing intervention.The values of clinical parameters including visual analogue scale(VAS)for pain and maximum inter-incisal opening(MIO)were compared preand post-operatively.The results were analyzed by paired t test with SPSS 24.0 software package.RESULTS:A total of54 patients met the inclusion criteria in this study.With the intervention of whole course rehabilitation nursing intervention,all patients presented with good cooperation and high compliance,and no patient was lost to follow-up.Meanwhile,all patients finished the postoperative mouth opening training and jaw pad treatment.During the follow-up of 6 months,the mean value of MIO increased from(31.76±7.40)mm(before treatment)to(35.24±6.22)mm(P=0.001)and the mean score of VAS decreased from 3.13±2.76 to 0.96±1.26(P=0.04).CONCLUSIONS:Full-time rehabilitation nursing provides a more comprehensive and individualized intervention,which effectively enhances the treatment of arthroscopic discopexy for patients of anterior disc displacement with perforation in TMJ by improving mouth opening,and relieving pain.

关 键 词：全程康复护理 关节盘前移位 关节盘穿孔 颞下颌关节镜 

分 类 号：R782.6[医药卫生—口腔医学]