上颌骨囊肿鼻内开窗术与唇龈沟切除术的临床分析
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摘要
目的对鼻内镜下应用低温等离子射频消融鼻内开窗术与经口腔唇龈沟切除术在上颌骨囊肿治疗中的优缺点进行分析探究,寻找治疗上颌骨囊肿的最佳途径。方法 50例诊断为上颌骨囊肿的患者,随机分为对照组和观察组,每组25例。对照组患者给予口腔唇龈沟切除术,观察组患者给予鼻内镜下低温等离子射频消融鼻内开窗术,所有患者术后随访24个月,观察比较2组患者的手术情况、术后反应、视觉模拟疼痛评分、术后复发及并发症发生情况。结果观察组患者的手术时间、术中出血量、伤口愈合时间明显少于对照组(P <0. 05),术后视觉模拟疼痛评分及术后反应明显优于对照组(P <0. 05),术后复发情况及并发症发生率明显低于对照组(P <0. 05)。结论鼻内镜下应用低温等离子射频消融鼻内开窗术治疗上颌骨囊肿具有出血少、创面小、手术时间短、患者疼痛少、术后反应及并发症少、复发率低等诸多优点,且便于术后观察术腔情况并进行及时有效的处理,可作为临床中的首选术式。
Objective To analyze the advantages and disadvantages of endoscopic low temperature plasma radiofrequency ablation of endoscopic sinus surgery and transoral gingival crevicectomy in treatment of maxillary bone cyst,and find out the best way to treat maxillary bone cyst. Methods A total of 50 patients who were diagnosed as maxillary bone cyst and were treated in our hospital from May 2010 to May 2015 were randomly divided into control group( n = 25) and observation group( n = 25). The patients in control group were treated by oral labial gingival crevicectomy,however the patients in observation group were treated by endoscopic low-temperature plasma radiofrequency ablation and endoscopic nasotomy. The surgical conditions,postoperative reactions,pain degree,postoperative recurrence and complications were observed and compared between the two groups. Results The operation time,intraoperative blood loss,wound healing time in observation group were significantly less than those in control group( P < 0. 05),and postoperative visual analog pain scores( VAS) and postoperative reactions were superior to those in control group( P < 0. 05). Moreover the incidence rates of postoperative relapse and complications in observation group were significantly lower than those in control group( P < 0. 05).Conclusion Application of low temperature plasma radiofrequency ablation nasal endoscopic fenestration in treatment of maxillary bone cyst has the advantages of less bleeding,small wound,shorter operation time,less pain,less postoperative reaction and complications,lower recurrence rate,therefore,it can be used as first choice in clinical surgery and is worthy of further popularization and application.
Objective To analyze the advantages and disadvantages of endoscopic low temperature plasma radiofrequency ablation of endoscopic sinus surgery and transoral gingival crevicectomy in treatment of maxillary bone cyst,and find out the best way to treat maxillary bone cyst. Methods A total of 50 patients who were diagnosed as maxillary bone cyst and were treated in our hospital from May 2010 to May 2015 were randomly divided into control group( n = 25) and observation group( n = 25). The patients in control group were treated by oral labial gingival crevicectomy,however the patients in observation group were treated by endoscopic low-temperature plasma radiofrequency ablation and endoscopic nasotomy. The surgical conditions,postoperative reactions,pain degree,postoperative recurrence and complications were observed and compared between the two groups. Results The operation time,intraoperative blood loss,wound healing time in observation group were significantly less than those in control group( P < 0. 05),and postoperative visual analog pain scores( VAS) and postoperative reactions were superior to those in control group( P < 0. 05). Moreover the incidence rates of postoperative relapse and complications in observation group were significantly lower than those in control group( P < 0. 05).Conclusion Application of low temperature plasma radiofrequency ablation nasal endoscopic fenestration in treatment of maxillary bone cyst has the advantages of less bleeding,small wound,shorter operation time,less pain,less postoperative reaction and complications,lower recurrence rate,therefore,it can be used as first choice in clinical surgery and is worthy of further popularization and application.
引文
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2 Ertas U,Yavuz MS.Interesting eruption of 4 teach associated with a large dentigerous cyst in mandible by only marsupializafion.Oral Maxillofac Surg,2003,61:728-730.
3连冈.鼻内镜下单纯鼻底开窗术治疗上颌骨囊肿的临床观察.临床耳鼻喉头颈外科杂志,2011,25:489-490,494.
4昊家森,谭汉提,刘柏松,等.经鼻内镜开窗治疗上颌骨囊肿的临床分析.中国耳鼻咽喉头颈外科,2013,20:307-310.
5陈京华,汤洪毅,郑艺,等.鼻内镜和普通开窗刮治术治疗上颌骨囊肿的疗效比较.包头医学院学报,2018,34:17-20.
6张洁,张燕琴.开窗减压术治疗颌骨囊肿与传统颌骨囊肿刮治术的临床治疗效果的对比分析.中国妇幼健康研究,2017,增刊:460-461.
7宋洪宁,李俊福,姜娟,等.颌骨囊肿开窗减压术治疗效果观察.泰山医学院学报,2018,39:867-869.
8 Cakarer S,Selvi F,Isler SC,et al.Decompression,enucleation,and implant placement in the management of a large dentigerouscyst.Craniofac Surg,2011,22:922-924.
9王春雨,王永福,赵元阳,等.鼻内镜手术治疗突至上颌窦的上颌骨囊肿11例.中国眼耳鼻喉科杂志,2017,17:132-134.
10刘春临.上颌骨囊肿治疗体会.临床医药文献杂志,2016,3:7713-7714.
11王朝山,孔繁勇,李力,等.鼻内镜下经鼻开窗术治疗大型上颌骨囊肿.中国耳鼻咽喉头颈外科,2015,22:47-48.
12廖军,叶晓明,林伟年,等.经鼻内镜下鼻道开窗治疗上颌骨囊肿13例临床观察.赣南医学院学报,2014,34:56-57,65.
13李福军,杨蓓蓓,王海军.鼻前庭囊肿发生机制的探讨.临床耳鼻喉头颈外科杂志,2007,21:82-83.
14陈京华,廖贵清,汤洪毅,等.富自体生长因子纤维蛋白凝胶对上颌骨囊肿切除术后骨缺损修复的长期疗效评估.河北医药,2018,40:2200-2204.
15靳职雷.开窗术治疗40例大型颌骨囊肿的临床疗效分析.全科口腔医学杂志,2017,4:20-22.
16李永湘,张武宁,毛海燕,等.鼻内镜下累及上颌窦或鼻底的上颌骨囊肿开窗切除术.中国医学文摘耳鼻咽喉科学,2017,32:86-87.
17昊家森,谭汉提,刘柏松,等.经鼻内镜开窗治疗上颌骨囊肿.中国耳鼻咽喉头颈外科,2013,20:307-310.
18刘刚.不同入路切口翻瓣在领骨囊肿切除术中的应用研究.世界最新医学信息文摘,2015,15:34-35.
19黄志爱,李鹏.鼻内镜下治疗上颌骨囊肿的临床观察.岭南急诊医学杂志,2017,22:187-189.
20刘英,李连伟.中老年颌骨囊肿手术疗效观察及感染控制分析.全科口腔医学杂志,2016,3:1-3.
21邓飞才,卢若煌,王月红,等.开窗减压术治疗颌骨囊肿54例临床研究.临床口腔医学杂志,2013,29:154-155.
22吴伟,潘凌峰,石宇远.开窗减压术治疗大型颌骨囊肿30例临床分析.中华全科医学,2015,13:1116-1118.
2 Ertas U,Yavuz MS.Interesting eruption of 4 teach associated with a large dentigerous cyst in mandible by only marsupializafion.Oral Maxillofac Surg,2003,61:728-730.
3连冈.鼻内镜下单纯鼻底开窗术治疗上颌骨囊肿的临床观察.临床耳鼻喉头颈外科杂志,2011,25:489-490,494.
4昊家森,谭汉提,刘柏松,等.经鼻内镜开窗治疗上颌骨囊肿的临床分析.中国耳鼻咽喉头颈外科,2013,20:307-310.
5陈京华,汤洪毅,郑艺,等.鼻内镜和普通开窗刮治术治疗上颌骨囊肿的疗效比较.包头医学院学报,2018,34:17-20.
6张洁,张燕琴.开窗减压术治疗颌骨囊肿与传统颌骨囊肿刮治术的临床治疗效果的对比分析.中国妇幼健康研究,2017,增刊:460-461.
7宋洪宁,李俊福,姜娟,等.颌骨囊肿开窗减压术治疗效果观察.泰山医学院学报,2018,39:867-869.
8 Cakarer S,Selvi F,Isler SC,et al.Decompression,enucleation,and implant placement in the management of a large dentigerouscyst.Craniofac Surg,2011,22:922-924.
9王春雨,王永福,赵元阳,等.鼻内镜手术治疗突至上颌窦的上颌骨囊肿11例.中国眼耳鼻喉科杂志,2017,17:132-134.
10刘春临.上颌骨囊肿治疗体会.临床医药文献杂志,2016,3:7713-7714.
11王朝山,孔繁勇,李力,等.鼻内镜下经鼻开窗术治疗大型上颌骨囊肿.中国耳鼻咽喉头颈外科,2015,22:47-48.
12廖军,叶晓明,林伟年,等.经鼻内镜下鼻道开窗治疗上颌骨囊肿13例临床观察.赣南医学院学报,2014,34:56-57,65.
13李福军,杨蓓蓓,王海军.鼻前庭囊肿发生机制的探讨.临床耳鼻喉头颈外科杂志,2007,21:82-83.
14陈京华,廖贵清,汤洪毅,等.富自体生长因子纤维蛋白凝胶对上颌骨囊肿切除术后骨缺损修复的长期疗效评估.河北医药,2018,40:2200-2204.
15靳职雷.开窗术治疗40例大型颌骨囊肿的临床疗效分析.全科口腔医学杂志,2017,4:20-22.
16李永湘,张武宁,毛海燕,等.鼻内镜下累及上颌窦或鼻底的上颌骨囊肿开窗切除术.中国医学文摘耳鼻咽喉科学,2017,32:86-87.
17昊家森,谭汉提,刘柏松,等.经鼻内镜开窗治疗上颌骨囊肿.中国耳鼻咽喉头颈外科,2013,20:307-310.
18刘刚.不同入路切口翻瓣在领骨囊肿切除术中的应用研究.世界最新医学信息文摘,2015,15:34-35.
19黄志爱,李鹏.鼻内镜下治疗上颌骨囊肿的临床观察.岭南急诊医学杂志,2017,22:187-189.
20刘英,李连伟.中老年颌骨囊肿手术疗效观察及感染控制分析.全科口腔医学杂志,2016,3:1-3.
21邓飞才,卢若煌,王月红,等.开窗减压术治疗颌骨囊肿54例临床研究.临床口腔医学杂志,2013,29:154-155.
22吴伟,潘凌峰,石宇远.开窗减压术治疗大型颌骨囊肿30例临床分析.中华全科医学,2015,13:1116-1118.