未成年人大型囊性成釉细胞瘤序列法治疗临床研究  

Clinical study of sequential treatment of large cystic ameloblastoma in minors

作　　者：彭笑 张晨晨 韩瑞 王栋 刘畅[1] 杜悦 高廷益[1] 张凯[1] PENG Xiao;ZHANG Chenchen;HAN Rui;WANG Dong;LIU Chang;DU Yue;GAO Tingyi;ZHANG Kai(Department of Stomatology,First Affiliated Hospital of Bengbu Medical College,233000,China)

机构地区：[1]蚌埠医学院第一附属医院口腔科,233000

出　　处：《实用口腔医学杂志》2023年第2期236-242,共7页Journal of Practical Stomatology

基　　金：安徽省2021高校学科(专业)拔尖人才学术资助项目(编号:gxbjZD2021058)。

摘　　要：目的:分析序列法治疗未成年人大型囊性经典型成釉细胞瘤(AM)的临床疗效及应用特点。方法:纳入未成年大型囊性经典型AM患者16例,采用序列法进行治疗,术后定期复诊并拍摄CBCT,应用Mimics 21.0计算患者术前及术后不同时期囊腔体积及骨质变化情况。应用SPSS 21.0软件处理数据,计量资料组间比较采用两独立样本t检验,计数资料采用χ2检验。结果:治疗后随访2~12年,16例患者中13例经开窗+首次内镜辅助下刮治后无复发,3例开窗+首次内镜辅助下刮治后复发,其中2例行二次刮治后随访至今无复发,1例首次刮治后复发遂行截骨修复治疗。所有患者,开窗术后9个月内囊腔体积不断减小,术后3、6、9个月囊腔平均减小率分别为25.34%、43.27%、49.85%(P<0.05);骨质生长情况良好开窗术后6~9个月囊腔体积变化不显著。开窗术后0~3、3~6、6~9个月的囊腔减小速率分别为5.23±1.58、4.21±1.34、1.85±0.72(cm3/月)。开窗术后3、6、9个月的骨密度较前不断提高(P<0.05)。结论:序列法能对未成年大型囊性经典型AM起到良好的治疗效果,开窗治疗能明显减小囊腔,配合后期刮治可有效清除病灶。Objective:To analyze the effects of sequence method in the treatment of large cystic classic ameloblastoma(AM)in minors.Methods:16 minor patients with classic AM underwent sequence therapy from May 2010 to April 2020 were included.Patients were followed up regularly after surgery and examid by CBCT.Mimics 21.0 software was used to calculate the tumor lesion volume,cyst volume and bone changes in the patients.SPSS 21.0 software was used to process the data.Two independent samples t test was used for the comparison between measurement data groups,andχ2 test was used for counting data.Results:Among the 16 patients,13 had no recurrence after fenestration followed by first endoscopic-assisted curettage,and 3 had recurrence after fenestration and first endoscopic-assisted curettage.Among them,2 had no recurrence after second curettage,and 1 patient had recurrence after first curettage and underwent osteotomy repair therapy.The tumor cavity volume of 16 patients continuously decreased by 25.34%,43.27%and 49.85%respectively at 3,6 and 9 months after surgery(all,P<0.05).No significant change was found in tumor cavity volume 6-9 months after treatment.The shrinkage rates of cyst cavity at 0-3 months,3-6 months and 6-9 months after curettage were 5.23±1.58,4.21±1.34 and 1.85±0.72(cm 3/month)respectively.Conclusion:The sequence therapy is effective in the treatment of cystic classic AM in minors since fenestration can significantly reduce the tumor cavity and the combined curettage can effectively remove the lesions.

关 键 词：经典型AM 序列法 囊腔减小速率 囊腔减小率 骨密度 

分 类 号：R739.8[医药卫生—肿瘤]