囊腔冲洗对颌骨囊性病变开窗减压术疗效的影响

目的探讨颌骨囊性病变开窗减压术后囊腔冲洗效率与疗效的关系。 方法回顾性分析2013年6月至2021年6月中山大学附属第五医院口腔颌面外科收治的颌骨囊性病变开窗术患者41例，其中男28例、女13例，年龄6 ~ 67岁，平均27.5岁；根据颌骨囊性病变大小、位置及深浅不同，术后囊腔冲洗方式分为脉冲式组（26例）和泵压式组（15例）；根据患者依从性差异导致每天冲洗次数不同分为：A组（18例），囊腔冲洗≤2次/d；B组（23例），囊腔冲洗≥3次/d。每2个月拍摄全颌曲面断层片，比较两组术后囊肿缩小情况。囊肿体积缩小率≥50%为显效，囊肿体积缩小率<50%为好转，囊肿无变化或增大为复发。对术后两组囊腔冲洗方式和每天冲洗次数的疗效进行统计学分析。采用SPSS 13.0软件包对数据进χ²检验。 结果41例患者中，脉冲式组术后有效率为53.8%；其中3例因囊腔深、不规则、囊腔间隔通畅性差，开窗术后囊肿体积增大；泵压式组（15例）术后有效率为60.0%；两组比较差异无统计学意义（χ² = 1.876，P>0.05）；A组术后有效率为38.9%，B组为69.6%，两组比较差异有统计学意义（χ² = 3.864，P<0.05）。 结论囊腔冲洗方式对开窗减压术后疗效无明显影响；囊腔冲洗≥3次/d及多方位彻底冲洗可提高开窗减压术后疗效，加快囊肿恢复。

Evaluation of the effect of capsule irrigation on marsupialization of jaw cystic lesions

ObjectiveTo investigate the relationship between capsule irrigation and curative effect after marsupialization for cystic lesions of jaw. MethodsAmong the patients admitted to oral and maxillofacial surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from June 2013 to June 2021, 41 patients with giant jaw cystic lesions (28 males and 13 females) were selected. The patients were aged from 6 to 67 years old, with an average of 27.5 years. According to the size, location and depth of jaw cystic lesions, the methods of postoperative capsule irrigation were divided into pulse group (26 cases) and pump pressure group (15 cases) . According to patient compliance, the patients were divided into two groups: Group A (18 cases) , cystic flushing <2 times/d; Group B (23 cases) , cystic flushing ≥3 times/d. The full jaw surface tomography was taken every 2 months to compare the reduction of cyst between the two groups. The evaluation criteria were set as follows: the reduction rate of cyst volume ≥50%: effective; the reduction rate of cyst volume <50%: improved; the cyst had no change or enlargement: recurrence. The curative effects of the two groups on the way of capsule irrigation and the times of irrigation every day were statistically analyzed by using SPSS 13. 0 with χ² test. ResultsAmong the 41 patients, the efficiency of postoperative cyst reduction in the pulse group (26 cases) was 53.8%, of which 3 cases had increased volume of cysts after marsupialization due to the depth, irregularity and poor cystic septal opening. The pump pressure group (15 cases) had an effective rate of postoperative cyst reduction of 60.0%, and there was no significant difference in the efficiency of cyst volume reduction between the two groups (χ² = 1.876, P>0.05) . Group A (18 cases) had an effective rate of postoperative cyst volume reduction of 38.9%, whereas the rate for group B (23 cases) was 69.6%, and the difference in the efficiency of cyst volume reduction in the two groups was statistically significant (χ² = 3.864, P<0.05) . ConclusionsThere was no effect of flushing methods on the clinical efficacy of capsule irrigation on the marsupialization of cystoid disease of the jaw. Capsule irrigation with ≥3 times/d significantly improved its efficacy on the marsupialization of cystoid disease of the jaw.