富血小板纤维蛋白膜在老年糖尿病患者牙周组织缺损再生中的应用效果研究  

Effects of platelet-rich fibrin membrane on the regeneration of periodontal tissue defects in elderly patients with diabetes

作　　者：李娜[1] 刘静[1] 范多娇 Li Na;Liu Jing;Fan Duojiao(Department of Stomatology,Second Hospital of Baoding City,Baoding,Hebei,071000,P.R.China;Office of Science and Education,Second Hospital of Baoding City,Baoding,Hebei,071000,P.R.China)

机构地区：[1]保定市第二医院口腔科,河北保定071000 [2]保定市第二医院科教处,河北保定071000

出　　处：《老年医学与保健》2023年第3期579-584,共6页Geriatrics & Health Care

基　　金：保定市科技计划项目(1941ZF013)。

摘　　要：目的探究富血小板纤维蛋白(Platelet rich fibrin,PRF)膜对老年糖尿病患者牙周组织缺损再生的治疗效果。方法选取2018年6月—2021年6月保定市第二医院口腔科收治的血糖控制良好的102例老年糖尿病牙周组织缺损患者为研究对象,通过随机数字表法分为对照组与观察组,每组51例。2组均由同一个经验丰富的团队行改良后的冠向复位瓣手术,观察组采取在缝合固定阶段置入制备好的PRF膜后缝合,对照组采取常规缝合,术后均给予2组患者相同的术后干预。观察并比较2组手术创面平均愈合时间、创面分泌物中胶原酶-1水平;评估并比较术后5 d时2组手术创面愈合率、疼痛、肿胀及渗血情况。术前及术后90 d患者来院复查时,记录并比较2组的牙龈退缩深度、牙周探查深度、角化组织宽度、平均牙根覆盖率与完全牙根覆盖率,同时评估并比较2组对治疗的满意度及术后并发症的发生情况。结果术后5 d,观察组手术创面愈合率明显高于对照组(P<0.05),创面分泌物中胶原酶-1的水平明显高于对照组(P<0.05),手术创面疼痛、肿胀及渗血的改善情况均明显优于对照组(P<0.05)。观察组手术创面的愈合时间明显短于对照组(P<0.05)。术后90 d,2组的牙周损坏情况相较于同组术前均有明显改善(P<0.05),观察组的牙周探查深度明显低于对照组(P<0.05),角化组织宽度、平均根面覆盖率及完全根面覆盖率明显高于对照组(P<0.05)。观察组患者对治疗的满意度明显高于对照组(P<0.05)。术后观察组并发症的发生率明显低于对照组(5.88%vs 21.57%)(P<0.05)。结论使用PRF膜可明显缩短患者手术创面的愈合时间,改善患者牙周损坏情况,有效降低术后并发症发生率,提高患者的治疗满意度。Objective To investigate the therapeutic effects of platelet-rich fibrin(PRF)membrane on regeneration of periodontal tissue defects in elderly patients with diabetes.Methods 102 elderly diabetic patients with periodontal tissue defects and good blood glucose control admitted to Department of Stomatology,Second Hospital of Baoding City from June 2018 to June 2021 were selected as the study subjects.They were divided into control group and observation group by random number table method,with 51 cases in each group.Both groups underwent modified coronal reduction valve surgery by the same experienced team.The observation group was sutured after the prepared PRF membrane was placed during the suture and fixation stage,while the control group received routine suture after operation.Both groups were given the same postoperative intervention after surgery.The mean healing time of surgical wound and the level of collagenase-1 in wound secretions were observed and compared between the two groups.The wound healing rate,pain,swelling and bleeding of the two groups were evaluated and compared 5 days after surgery.The depth of gingival recession,depth of periodontal exploration,width of keratinized tissue,average root coverage rate and complete root coverage rate were recorded and compared between the two groups before surgery and at 90 days after operation.The satisfaction with treatment and the occurrence of postoperative complications were also compared between the two groups.Results On the 5th day after surgery,the wound healing rate of the observation group was significantly higher than that of the control group(P<0.05),the level of collagenase-1 in the wound secretion was significantly higher than that of the control group(P<0.05),and the improvement of the pain,swelling and bleeding of the surgical wound was significantly better than that of the control group(P<0.05).The healing time of surgical wound of the observation group was significantly shorter than that of the control group(P<0.05).On the 90th day after surgery

关 键 词：老年 糖尿病 牙周损伤 并发症 富血小板纤维蛋白膜 牙周组织再生 

分 类 号：R587.2[医药卫生—内分泌] R781.4[医药卫生—内科学]