开窗减压联合生物材料填充治疗颌骨大型囊性病变的研究

目的:评价开窗减压术联合生物材料硫酸钙填充治疗颌骨大型囊性病变的临床疗效。方法:选取颌骨大型囊性病变患者70例,随机均分为观察组和对照组,观察组行I期开窗减压保守治疗,待囊肿明显缩小后行Ⅱ期小囊肿刮除术并硫酸钙生物材料充填术;对照组行传统颌骨囊肿刮除术,同时予以硫酸钙生物材料充填术。观察并比较两组患者手术时间、术中出血量、术后疼痛及感染、囊腔体积缩小程度、骨质增生厚度及骨密度值、术后复发率及神经性并发症发生情况。结果:两组患者手术时间、术中出血量、术后疼痛及感染发生率相比差异具有统计学意义(P＜0.05);术后6月各指标较术后3月均明显改善,观察组术后3、6月囊腔缩小值、术后骨质增生厚度、术后骨质密度值均优于对照组,差异具有统计学意义(P＜0.05);术后均随访12~24月,对照组1例复发,观察组无复发,差异无统计学意义。结论:采用开窗减压术治疗颌骨大型囊性病变手术创伤小,可保护囊肿周围血管神经等重要结构;在囊肿刮出后采用医用硫酸钙充填缺损骨腔,防止软组织嵌入,加快了成骨速度,降低术后复发。

Clinical Analysis of the Treatment of Jaw Cyst Fenestration Decompression and Biomaterial Filling.

Objective: To evaluate the decompression combined with calcium sulfate with clinical curative effect of the treatment of jaw cysts. Methods: From 2009 August -2013 year in August in our hospital were the large jaw cystic lesions in patients with a total of 70 cases, all patients were informed of the pros and cons of communication before operation, and the risk in patients with various kinds of treatment plans, according to the wishes of patients, divided into the observation group and the control group, the observation group of 35 cases received conservative treatment, I window decompression, the cysts reduced obviously after II small cyst curettage and calcium sulfate biological material filling operation, the control group of 35 cases, treated with traditional jaw cyst curettage, and calcium sulfate biological material filling, observed and compared two groups of patients with operation time, bleeding volume during operation, postoperative pain, postoperative, infections, cystic cavity size, degree of hyperplasia of bone thickness and bone density measurements, the incidence of recurrence and neuropathic complications were compared between the two groups at the same time. Results: The two groups of patients with operation time, intraoperative bleeding volume, postoperative pain and postoperative infection rate of phase difference was statistically significant (P<0.05); the two groups of patients after 6 months the index operation after 3 months were significantly improved, the observation group of patients after 3 months and after 6 month sac cavity was reduced in value, postoperative bone hyperplasia thickness value, postoperative bone density measurements were superior to the control group, the difference was statistically significant (P<0.05). All patients were followed up for 12 to 24 months, the control group 1 patients relapse, the observation group without recurrence, two groups of patients relapse rate difference does not have statistical significance (P<0.05). Conclusion: The clinical effect of large cystic lesions of the jaw is good with open window decompression, and it is worth to be popularized in clinic.