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目的探讨透明质酸钠关节上腔和关节下腔注射在治疗颞下颌关节骨关节病中的疗效。方法选择2006年7月至2009年2月威海市立医院口腔门诊适合注射透明质酸钠的46例颞下颌关节骨关节病患者,随机分为试验组和对照组,试验组25例采用关节下腔注射透明质酸钠,对照组21例采用关节上腔注射,比较两组疗效的差异。结果张口度对照组平均增加(0.96±0.13)cm,试验组平均增加(1.28±0.09)cm,两组间差异有统计学意义(P<0.01);关节疼痛对照组平均缓解(23.43±9.62)mm,试验组平均缓解(29.08±10.51)mm,两组间差异有统计学意义(P<0.01)。治疗后3个月至6个月的症状改善进行比较,张口度对照组变化为(0.01±0.03)cm,试验组为(0.08±0.04)cm,差异无统计学意义;关节疼痛改善对照组为(1.64±0.56)mm,试验组为(4.24±0.79)mm,差异具有统计学意义(P<0.01)。结论透明质酸钠关节上、下腔注射对颞下颌关节骨关节病确有疗效,关节下腔注射较上腔注射对缓解患者的关节疼痛和改善张口度的效果更为明显,且对疼痛缓解的作用时间更持久。

A clinical study on intraarticular injection of hyaluronate for treatment of temporomandibular osteoarthrosis

Abstract：Objective To investigate the effect on temporomandibular joint osteoarthrosis of injecting sodium hyaluronate（HA）into both superior and inferior temporomandibular joint cavities. Methods Forty-six cases of temporomandibular joint osteoarthrosis enrolled from the Department of Oral and Maxillofacial Surgery of Weihai Municipal Hospital from 2006 to 2009 were randomly divided into two groups. In a group of 21 cases， HA was injected into the superior cavity，while in another group of 25 cases， HA was injected into the inferior cavity. A retrospective cohort study was used to analyze the data of two groups. Results The group of superior injection gained better clinical therapeutic effects， not only on maximal mouth opening but also the pain scores. Conclusion Injection of sodium hyaluronate into superior cavity is a good method to treat the temporomandibular joint osteoarthrosis.