下颌骨骨折临床回顾性研究.docVIP

下颌骨骨折临床回顾性研究 　　[摘要]目的：探讨下颌骨骨折后治疗方法的适应证和治疗效果。方法：对从2005年1月～2010年1月来我院就诊的143例下颌骨骨折患者的治疗效果及随访结果进行总结。结果：牙槽突骨折采用颌间拴丝或牙弓夹板,髁突颈骨折多采用颌间牵引固定；大部分患者采用切开复位，断端选用钛合金小型钛板或钢丝结扎固定，少部分患者采用颌间结扎、颌间拴丝弹性牵引辅以颅颌绷带保守治疗，均取得较好效果，总成功率为95.4%。通过术后1～6年的随访，按3个等级进行分类：I级：伤口愈合好，骨折端无错位愈合，钛板无感染或暴露需二次手术取出，无开口困难等功能障碍；II级：伤口愈合良好，骨折端无错位愈合或轻微错位不影响功能，钛板无感染或暴露需二次手术取出，无或者轻中度功能障碍；III级：伤口感染，骨折断端感染或长期不愈合，钛板感染或暴露需要二次手术取出，有重度开口困难等功能障碍；随访结果3个等级分别为I级40例，占27.9%，II级92例，占64.8%，III级11例，占7.3%。结论：下颌骨骨折正确地选择适应症是各种治疗下颌骨骨折方法取得满意疗效的关键。准确诊断，及时复位、固定，选择正确固定方式，防止感染，待别是应用坚强内固定技术能有效提高颌骨骨折治愈率。 　　[关键词]下颌骨骨折；适应证；坚强内固定；并发症 　　[中图分类号]R782 [文献标识码]A [文章编号]1008-6455（2011）05-0753-03 　　 　　Retrospective clinical study on mandibular fracture treatment 　　WANG Lin1,LI Shan2,LIU Ya-rui3 　　(1.Department of Orthodontics,Xiangyang Stomatological Hospital,Xiangyang 441003,Hubei,China;2.Department of stomatology, Bethune medical College;3.Department of Stomatology,Stoma tological hospital of Guangzhou Medical University) 　　 　　Abstract: ObjectiveTo investigate the indications and management effects of fracture of mandible.Methods 143 mandibular fracture patients were presented and treated with different methods from Jan 2005 to Jan 2010 in our hospital.The relationship between methods and treatment efficiency were appraised objectively.Results Different ways had different advantages,and the total successful rate was 95.4%. The treatment outcomes were evaluated according to three classifications,there were 40 cases belonging to I type(27.9%);92 cases belonging to II type(64.8%);11 cases belonging to III type(7.3%). Conclusion Titanium mimi-plate was a promising reliable method for mandibular fracture treatment,which can surely increase the success rate of treatment.Its crucial to select a right method in the mandibular fracture treatment. 　　Key words:mandibular fracture;indication;internal rigid fixation;complication 　　 　　下颌骨骨折是由于下颌内受到暴力所致外伤性疾病，下颌骨是颌面部唯一可动的骨骼，骨质结构远较上颌骨致密，由于处于面下份的位置，可接受多方向的暴力，因而下颌骨骨折比较常见[1-2]。现将我科2005年1月～2010年1月收治的143例下颌骨骨折病例进行