钛钉颌间固定结合弹力帽辅助固定法与钛板内固定联合钛钉颌间牵引法在下颌骨骨折治疗中的临床应用比较

doi:10.3969/j.issn.1006-6233.2023.05.017

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摘要 目的:比较钛钉颌间固定结合弹力帽辅助固定法与钛板内固定联合钛钉颌间牵引法对下颌骨骨折的治疗效果。方法:将2020年1月至2022年10月我院收治的102例下颌骨骨折患者纳入研究。根据电脑随机法将患者分为两组,观察组患者(n=51)行钛钉颌间固定结合弹力帽辅助固定治疗,对照组(n=51)采用钛板内固定联合钛钉颌间牵引法治疗。评估患者术后疗效,比较治疗前后患者的口腔卫生,包括社区牙周治疗量表指数(CPI)、牙龈指数(GI)及软垢指数(DI),分析患者的咀嚼、口腔功能,评估患者的颌面部情况,统计患者术后的不良反应,并对其发生率进行计算。结果:经治疗,观察组患者的治疗有效率(90.38%)与对照组(94.23%)相比无统计学差异(P>0.05)。经治疗两组患者的CPITN、GI、DI指数升高,观察组患者的各指标升高幅度均大于对照组患者(P<0.05)。治疗后,观察组的咀嚼、开口功能及颌面部情况评分降低幅度均大于对照组(P<0.05)。观察组患者不良反应发生率(9.62%)低于对照组(25.49%),P<0.05。结论:钛钉颌间固定结合弹力帽辅助固定法用于下颌骨骨折治疗可以缩短患者治疗时间,提高患者术后口腔卫生,促进患者颌面部恢复,减少不良反应的发生。

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关键词 ：钛钉颌间固定结合弹力帽辅助固定, 钛板内固定联合钛钉颌间牵引, 下颌骨骨折, 口腔卫生, 颌面部情况

Abstract：Objective:To compare the effect of titanium nail intermaxillary fixation combined with elastic cap assisted fixation and micro titanium plate internal fixation combined with titanium nail intermaxillary traction on mandibular fracture. Methods: A total of 102 patients with mandibular fracture admitted to our hospital from January 2020 to October 2022 were included in the study. All patients were divided into observation group and control group according to the computer randomization method. The observation group patients (n=51) were treated with titanium nail intermaxillary fixation combined with elastic cap assisted fixation treatment, and the control group patient(n=51) was treated with titanium plate internal fixation combined with titanium nail intermaxillary traction method. The postoperative efficacy of patients was evaluated, and the oral hygiene of patients before and after treatment was compared, including the Community Periodontal Treatment Scale Index (CPI), Gingival Index (GI), and Soft Dirt Index (DI). The patients' chewing and oral functions was analyzed, the patients' maxillofacial conditions was evaluated, the patients' adverse reactions after surgery was counted, and their incidence was calculated. Results: After treatment, there was no significant difference in the response rate (90.38%) and the control group (94.23%) (P>0.05). CPITN, GI and DI indexes increased in both treated groups, and increased more in the observation group than in the control group (P<0.05). After treatment, the lower scores of chewing, opening function and maxillofacial condition in the observation group were greater than in the control group (P<0.05). The incidence of adverse reactions in the observation group was 9.62%, lower than that in the control group (25.49%), with a statistically significant difference (P<0.05). Conclusion: The titanium nail intermaxillary fixation combined with elastic cap assisted fixation can shorten the treatment time of patients with mandibular fracture, improve the oral hygiene of patients after surgery, promote the recovery of patients' maxillofacial region, and reduce the occurrence of adverse reactions.

Key words： Titanium nail intermaxillary fixation combined with elastic cap auxiliary fixation Titanium plate internal fixation combined with titanium nail intermaxillary traction Mandible fracture Oral hygiene Maxillofacial condition

基金资助:安徽省卫生健康委科研项目,(编号:AHWJ2021b111);2019年阜阳市卫健委课题,(编号:FY2019-049)

通讯作者: 陈旭兵

引用本文:

刘效文, 柳兆刚, 田宏伟, 周宇, 唐振华, 陈旭兵. 钛钉颌间固定结合弹力帽辅助固定法与钛板内固定联合钛钉颌间牵引法在下颌骨骨折治疗中的临床应用比较[J]. 河北医学, 2023, 29(5): 785-789.
LIU Xiaowen, LIU Zhaogang, TIAN Hongwei, et al. Comparison of the Clinical Application of Titanium Nail Intermaxillary Fixation Combined with Elastic Cap-Assisted Fixation Method and Titanium Plate Internal Fixation Combined with Titanium Nail Intermaxillary Traction Method in the Treatment of Mandible Fracture. HeBei Med, 2023, 29(5): 785-789.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.017 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/785

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