透明质酸钠关节腔内注射治疗颞下颌关节紊乱病的疗效分析

目的　比较透明质酸钠颞下颌关节上腔注射和上下腔注射对颞下颌关节紊乱病的疗效。方法　纳入294 例颞下颌关节紊乱病患者,随机分为两组。一组186例采用颞下颌关节上腔注射透明质酸钠,另一组108例采用上下腔注射。用回顾性队列研究方法比较两组疗效的差异。结果　上下腔注射组患者开口度平均增加6·29 mm,上腔注射组平均增加3·82 mm,两组间有显著差异(P=0·001)。上下腔注射组患者关节疼痛平均缓解44%,关节上腔注射组平均缓解37%,两组间有显著差异(P=0·039)。结论　透明质酸钠注射对颞下颌关节紊乱病确有疗效,其中关节上下腔同时注射较单纯上腔注射可更有效缓解患者的关节疼痛和改善张口度,该趋势在骨关节炎和关节盘不可复性前移位患者更为明显。

An Outcome Analysis of Two Methods of Intra-Capsular Injection of Sodium Hyaluronate for Temporomandibular Disorders

Objective To analyze the treatment outcome of the two methods of intra-capsular injection of temporomandibular joints, the upper capsule alone and both the upper and lower capsules, for different subtypes of temporomandibular disorders.Methods A retrospective cohort study was designed, based on the outpatients and the data which were obtained from West China Stomatological Hospital, Sichuan University. SPSS10.0 software was used to analyze the data, which were collected before the operation and one week after the operation.Results 294 patients were followed up. The group of double capsules injection gained better prospect, not only on the mouth-opening but also the pain-cured, especially in two subgroups such as the anterior dislocation of disc without reduction and the osteoarthritis of TMJ.Conclusion It seems that the double capsules injection of sodium hyaluronate for TMD can gain better outcome than the upper capsule injection, but a clinical randomized controlled test and a long-term follow-up study of the two methods are needed to verify this finding.