开窗、负压吸引、刮治术治疗牙源性颌骨囊性病变的对比研究

目的:对比研究开窗减压术、负压吸引术、刮治术对牙源性颌骨囊性病变的临床疗效。方法:选取牙源性颌骨囊性病变30例,病变最大径>3.5 cm的20例患者进入甲组,并根据患者意愿分为甲组A(开窗减压)11例、甲组B(开窗负压吸引)9例;最大径<3.5 cm的10例患者进入乙组,根据患者意愿分为乙组A(开窗减压)5例和乙组B(手术刮治)5例。测量治疗过程中囊腔体积变化及曲面体层片缺损面积,比较囊性缺损缩小速度,应用SPSS 11.0软件包对病变范围的缩小情况量化后进行统计学分析。结果:甲组A开窗减压和甲组B负压吸引囊腔愈合良好,6个月后囊腔体积减少平均百分率为63.66%和83.52%,囊腔面积减少平均百分率为65.86%和88.65%,甲组B与甲组A有显著差异,P<0.05;乙组B一次手术刮治治疗组6个月后颌骨形态与结构基本恢复正常,有效率100%,乙组A有效率为60%。结论:负压吸引术较开窗减压术对大型牙源性颌骨囊性病变有更好的治疗作用,具有广阔的应用前景;小型牙源性颌骨囊性病变最好选择一次性手术刮治治疗。

Comparison of fenestration,suction drainage and curettage for odontogenic cystic lesions of the jaw bones

PURPOSE： To compare the clinical effects of fenestration and decompression technique, suction drainage and curettage for odontogenic cystic lesions of the jaws bones. METHODS： Odontogenic cystic lesions of jaw bones with a maximum diameter bigger than 3.5 cm were served as group one, and subdivided into group A （fenestration and decompression technique） and group B （suction drainage） according to the patients＇ desire. The lesions with a maximum diameter less than 3.5 em were served as group two,and subdivided into group A （fenestration and decompression technique） and group B （curettage） according to the patients＇ desire. The evaluation for group one and two was done by measuring the cystic lesion during the treatment and comparing the speed of the reduction of the cystic area by panoramic view. Statistical analysis was performed after quantification for the lesions reduction using SPSS 11.0 software package. RESULTS： The healing of cystic cavity was good both in group A and group B of group one. After 6 months,the percentage of the reduction for the lesion volume was 63.66% and 83.52 %, respectively ;the percentage of the reduction for the lesion area was 65.86% and 88.65 %. There was significant difference between them （P〈0.05）. In group B （surgery alone） of group two,after 6 months,the jaw bone had normal shape and the efficiency was 100%. In group A of group two, the efficiency was 60%. CONCLUSIONS： Suction drainage had a better effect for big jaw cystic lesions than fenestration and decompression technique. It is worthy of wide application. Surgical curettage is applicable to small odontogenic cystic lesions of the jaw bones. Supported by Natural Science Foundation of Inner Mongolia Autonomous Region（2011BS 1102）.