聚左旋丙交酯板内固定联合颌间牵引钉外固定治疗颌骨骨折效果观察及对炎性因子、颞颌关节功能的影响  

Effect of Internal Fixation with Polyl-lactide Plate Combined with Intermaxillary Traction Nail External Fixation on Jaw Fracture and Its Effect on Inflammatory Factors and Temporomandibular Joint Function

作　　者：王培[1] 周彪[1] 马永平[1] WANG Pei;ZHOU Biao;MA Yong-ping(Department of Stomatology,the Second Hospital of Baoding City,Baoding,Hebei 071051,China)

机构地区：[1]保定市第二医院口腔科,河北保定071051

出　　处：《临床误诊误治》2023年第2期113-117,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会基金项目(20200170)。

摘　　要：目的探究聚左旋丙交酯板内固定联合颌间牵引钉外固定治疗颌骨骨折的效果及对炎性因子、颞颌关节功能的影响。方法选取2020年7月-2022年7月收治的113例颌骨骨折,将其中57例采用聚左旋丙交酯板内固定联合颌间牵引钉外固定治疗者作为研究组,56例采用微型钛板内固定联合颌间牵引钉外固定治疗者作为对照组。比较2组治疗效果、骨折愈合时间、术后并发症发生情况,以及手术前后口腔功能、血清炎性因子水平、骨痂评分、生活质量、颞颌关节评分。结果2组治疗优良率比较差异无统计学意义(P>0.05)。2组术后6个月固定情况、咀嚼功能、舒适度、口腔美观评分较术前明显提高,且研究组术后6个月舒适度评分较对照组高(P<0.05,P<0.01)。2组术后3个月血清C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平较术前明显降低,且研究组较对照组低(P<0.05,P<0.01)。研究组骨折愈合时间较对照组短,术后1、2、3个月骨痂评分较对照组高(P<0.01)。2组术后3、6个月口腔健康影响程度量表(OHIP-14)评分、颞颌关节评分均较术前明显降低,且研究组术后3个月OHIP-14评分、颞颌关节评分较对照组低(P<0.05,P<0.01)。研究组术后并发症发生率低于对照组(P<0.05)。结论聚左旋丙交酯板内固定联合颌间牵引钉外固定治疗颌骨骨折,能获得与微型钛板内固定联合颌间牵引钉外固定相近的治疗效果,且能下调术后血清炎性因子水平,有利于促进术后颞颌关节功能恢复、降低术后并发症发生率。Objective To explore the effect of internal fixation with polyl-lactide plate combined with external fixation with intermaxillary traction nail in the treatment of jaw fracture and its effect on inflammatory factors and temporomandibular joint function.Methods A total of 113 cases of jaw fracture treated from July 2020 to July 2022 were selected.Among them,57 cases were treated with polyl-lactide plate internal fixation combined with intermaxillary traction nail external fixation as the research group,and 56 cases were treated with titanium plate internal fixation combined with intermaxillary traction nail external fixation as the control group.The therapeutic effect,fracture healing time,postoperative complications,as well as oral function,serum inflammatory factor level,callus score,quality of life and temporomandibular joint score before and after surgery were compared between the two groups.Results There was no significant difference in excellent and good rate between the two groups(P>0.05).The scores of fixation,masticatory function,comfort level and oral aesthetics in the two groups were significantly improved at 6 months after surgery,and the score of comfort level in the research group was higher than that in the control group at 6 months after surgery(P<0.05,P<0.01).The levels of serum C-reactive protein,tumor necrosis factor-αand interleukin-6 in the two groups were significantly decreased at 3 months after surgery,and the levels in the research group were lower than those in the control group(P<0.05,P<0.01).The fracture healing time of the research group was shorter than that of the control group,and the callus score was higher at 1,2 and 3 months after surgery(P<0.01).The scores of the Oral Health Impact Scale(HIP-14)and score of temporomandibular joint in the two groups at 3 and 6 months after surgery were significantly lower than those before surgery,and the scores in the research group were lower than those in the control group at 3 months after surgery(P<0.05,P<0.01).The incidence of postoperativ

关 键 词：颌骨折 内固定 聚左旋丙交酯板 肿瘤坏死因子-α 并发症 

分 类 号：R782.4[医药卫生—口腔医学]