基于逆向工程技术测量分析云南白药对正颌外科术后面部肿胀程度的影响

目的 建立量化测量组织肿胀度的研究方法,评价围手术期口服云南白药对正颌外科术后面部肿胀程度的影响.方法 将同期行Le Fort I型截骨术和双侧下颌升支矢状劈开截骨术的牙颌面畸形患者根据随机数字表分为试验组和对照组,分别于术前3 d和术后5 d 口服云南白药胶囊或安慰剂胶囊.在术前、术后第3天、1周和1个月行颌面部三维扫描,重建面部三维曲面模型.将各时点模型与基准模型重叠配准,然后用逆向工程软件测量面部肿胀体积、肿胀消退厚度和幅度.结果 40例患者完成了各时期面部三维扫描重建,其中试验组18例,对照组22例.术后1周内试验组和对照组平均最大肿胀消退厚度分别为3.6 mm和2.3mm,两组比较差异具有统计学意义.术后1周内试验组和对照组面部肿胀变化幅度分别为49.O%和38.3%,两组比较差异有统计学意义.两组术后肿胀消退程度和速度比较,差异无统计学意义.结论 围手术期口服云南白药减轻了正颌外科术后面部组织肿胀程度,加快了肿胀消退速度.云南白药具有减轻外科手术后组织肿胀作用.

Reverse-engineering-based quantitative three-dimensional measurement of facial swelling after administration of yunnan Baiyao following orthognathic surgery

Objective To evaluate the effects of periopemtive oral administration of Yunan Baiyao on reduction of postoperative facial swelling following bimaxillary orthognathic surgery. Methods Patients scheduled for Le Fort I esteotomies and bilateral sagittal split ramus osteotomies were enrolled in the prospective, randomized, double-blind, placebo-controlled clinical study. Patients were orally administrated with Yunnan Baiyao capsules or placebo capsules before 3 days of operation and 5 days post-operation. Three-dimensional face images were recorded with OKIO-SC-400 Scanning System in 40 patients at pre-operation, postoperatively 3 day, 1 week and 1 month. Facial scans from different time periods were registrated to same coordinates and overlaid onto the baseline facial scan. 3D and 2D model deviations were performed with reverse engineering software to compare the differences between each two models and to quantitatively determine the reductions in facial swelling. Results There were 18 patients in Yunnan Baiyao group and 22 patients in control group. The severe swelling region was in the cheek, followed by the upper and lower lip. The average reduction of swelling thickness in Yunnan Baiyao group and control group from 3 day to 1 week postoperative was 3.6 mm and 2.3 nun respectively; there was significant difference between the two groups. Significant differences were also found in percentage changes of facial morphology from 3 day to 1 week postoperative (49.0% and 38.3% respectively). There were no significant changes in facial volumes of swelling between the two groups. Conclusions Perioperative oral administration of Yunnan Baiyao capsules can effectively reduce the magnitude of facial swelling in bimaxillary orthognathic surgery. Yunnan Biayao has efficacy of anti-inflammatory response.