改良切口入路治疗颧上颌复合体骨折的临床效果研究  

Retrospective analysis of modified incision approach in the treatment of zygomatic maxillary complex fractures

作　　者：朱辞名 王帅 张力 朱浩 隋健夫 Zhu Ciming;Wang Shuai;Zhang Li;Zhu Hao;Sui Jianfu(Department of Maxillofacial Surgery,General Hospital of Northern Theater Command,Shengyang 110016,China)

机构地区：[1]北部战区总医院口腔颌面外科,沈阳110016

出　　处：《中国临床实用医学》2025年第1期36-40,共5页China Clinical Practical Medicine

基　　金：沈阳市科技计划项目(24-214-3-115)。

摘　　要：目的探讨改良切口入路治疗颧上颌复合体骨折的临床效果。方法本研究为回顾性病例对照研究,选取2021年1月至2023年1月北部战区总医院口腔颌面外科治疗的70例口腔颌面部骨折患者,男41例,女29例,年龄(30.08±5.53)岁,年龄范围为20~46岁。根据治疗方法的不同,将患者分为改良组与传统组,每组35例。改良组患者给予经口内上颌前庭沟切口入路附加眉弓微创切口,以反弧形钛板固定眶下缘骨折断端,以钛板分别固定颧牙槽嵴支柱及颧额缝骨折断端,手术治疗颧上颌复合体骨折;传统组患者给予睑缘切口入路、结合口内前庭沟切口入路附加眉弓微创切口,钛板分别固定眶下缘、颧额缝及颧牙槽嵴骨折断端,手术治疗颧上颌复合体骨折。比较两组患者的骨折愈合效果、手术并发症、美观满意度、颌面功能及治疗效果。结果两组患者的愈合率均为100.0%,差异无统计学意义(P>0.05)。改良组患者的治疗后的不良反应发生率[5.7%(2/35)]低于传统组[8.6%(3/35)];改良组患者的满意度[100.0%(35/35)]高于传统组[94.3%(33/35)];改良组患者的开口程度评分[(2.42±0.44)分]、咀嚼功能评分[(2.34±0.49)分]高于传统组[(1.96±0.36)分、(1.91±0.38)分],差异均有统计学意义(P<0.05)。结论改良切口入路治疗颧上颌复合体骨折,可以有效避免睑缘切口形成的瘢痕挛缩及睑外翻,美观修复效果好,同时手术安全性较高,颌面部功能恢复效果较佳。ObjectiveTo investigate the clinical effect of modified incision approach in the treatment of zygomatic maxillary complex fractures.MethodsThis was a retrospective case-control study,a total of 70 patients with oral and maxillofacial fractures treated in the department of Maxillofacial Surgery in the General Hospital of Northern Theater Command from January 2021 to January 2023 were selected,including 41 males and 29 females,aged(30.08±5.53)years old,the age ranging from 20 to 46 years oid.According to the different treatment methods,the patients were divided into the improved group(n=35)and the traditional group(n=35).The patients in the improved group were treated with intraoral maxillary vestibular groove incision and eyebrow arch minimally invasive incision,the fracture ends of the inferior orbital margin were fixed with anti arc titanium plate,the fracture ends of zygomatic alveolar ridge strut and zygomatic frontal suture were fixed with titanium plate,and the zygomatic maxillary complex fractures were treated with surgery;The patients in the traditional group were treated with palpebral margin incision approach,combined with intraoral vestibular groove incision approach plus eyebrow arch minimally invasive incision,titanium plate fixation of the inferior orbital margin,zygomatic frontal suture and zygomatic alveolar ridge fracture ends,and the zygomatic maxillary complex fractures were treated with surgery.The fracture healing effect,surgical complications,aesthetic satisfaction,maxillofacial function and treatment effect of the two groups were compared.ResultsThe total healing rate of the two groups was 100.0%,and the difference was not statistically significant(P>0.05).The incidence of adverse reactions after treatment in the improved group[5.7%(2/35)]was lower than that in the traditional group[8.6%(3/35)];The total satisfaction of patients in the improved group[100.0%(35/35)]was higher than that in the traditional group[94.3%(33/35)];The opening degree score[(2.42±0.44)points]and masticatory function

关 键 词：上颌骨 上颌前庭沟切口入路 睑缘切口 坚固内固定术 颧上颌复合体 

分 类 号：R782.4[医药卫生—口腔医学]