行关节腔内注射醋酸强的松龙治疗颞颌关节紊乱综合征

目的采用醋酸强的松龙作关节上腔或关节下腔注射1～3次,针对治疗观察疼痛、弹响或杂音和开口障碍三大症状的疗效。方法86例颞颌关节紊乱综合征患者（TMJDS）中,关节上腔注射治疗Ⅰ类翼外肌亢进型的弹响开口过大症状22例,Ⅱ类关节囊松弛、盘突失调的可复性盘前移者40例,Ⅲ类关节窝、关节结节骨质改变者8例,关节下腔注射治疗Ⅲ类髁突骨质改变者16例。结果关节腔注射醋酸强的松龙对治疗TMJDS的Ⅰ、Ⅱ、Ⅲ类的弹响杂音有效治疗率分别为90％、87．5％、70．8％。对Ⅱ、Ⅲ类的疼痛不适的有效治疗率分别为72．2％、75％;对Ⅰ、Ⅱ、Ⅲ类的开口障碍治疗有效率分别为44．4％、50％、46％。结论该疗法对TMJDS三类之弹响杂音症状的疗效较为满意,对三类之疼痛症状的疗效一般,对三类之开口障碍症状的疗效欠佳,提示对TMJDS患者以弹响杂音为主要症状的治疗首选此法较好。

Clinical study of aticulare cavity injection with prednisolone acetate to treat temporomandibular joint disturbance syndrome

Objective To investigate the clinical effect of aticulare injection with prednisolone acetate to treat TMJDS.Methods Eighty-six patients were adopted in this study in which 22 cases with wing-tpye I muscle hyper-snapping or open excessive symptoms,40 cases Ⅱ-type with flabby joint capsule and dysfunction of articular dise.8 cases type Ⅱ with fossa and joint improvement of bone nodules were received injection in superior articular cavity.16 cases of type Ⅲ condyle bone changes treated with inferior vena joint injection.Results Intra-articular injection of prednisolone acetate in treatment of TMJDSI,Ⅱ,Ⅲ class snapping noise efficiency were 90%,87.5%,70.8% respectively.For type Ⅱ,Ⅲ types of difficulty to open showed efficiency of 44.4%,50%,46%.Conclusions zintra-articular injection of prednisolone acetate in treatment of TMJDS,snapping noise of the three types were more satisfied;the pain symptoms had general effect;Obstacle in opening showed poor effects suggested that the methods to treat patients with TMJDS of snapping noise as the main symptoms is efficient.