颌骨骨析临床治疗的探讨.docVIP

颌骨骨析临床治疗的探讨 　　[摘要] 目的 探讨不同类型颌骨骨折的临床治疗方法及护理要点。方法 上颌骨骨折15例，下颌骨骨折34例，上下颌骨骨折5例，其中合并颅脑损伤伴发脑脊液鼻漏耳漏4例，年龄28～55岁。下颌骨骨折及上颌骨单线骨折采用内固定钛板坚固内固定术，其余病例采用坚固内固定术术后3～5 d附加牙弓夹板颌间弹性牵引复位治疗。结果 所有患者均取得了满意的恢复咬颌关系的良好治疗效果，术后患者咬合关系恢复良好，张口度及咀嚼功能良好，X线复查骨折愈合良好。结论 内固定钛板坚固内固定术具有操作简便，骨断端固定牢靠，术后病人口腔功能恢复良好及口腔卫生易于护理等优点。对于上颌骨多线骨折及合并有颅脑损伤不宜采用经鼻气管插管病人，需术后辅助牙弓夹板颌间弹性牵引治疗，疗效满意。 　　[关键词] 颌骨骨折；坚固内固定；咬颌关系；颌间弹性牵引 　　[中图分类号] R739.91 [文献标识码] A [文章编号] 1674-0742（2014）04（b）-0061-02 　　[Abstract] Objective To explore the clinical treatment and nursing of different kinds of jaw bone fracture. Methods 15 cases of maxillary fracture， 34 cases of mandible fracture， 5 cases of maxillary and mandible fracture， among which there were 4 cases complicated by craniocerebral injury and cerebrospinal rhinorrhea and otorrhea， aged between 28 and 55. Rigid internal fixation with titanium alloy plate were applied to mandible fracture and single fracture of maxilla； For other cases， intermaxillary elastic traction therapy with dental arch splint were applied 3-5 days after rigid internal fixation. Results The occluding function of all the patients was well restored. After the treatment， patients recovered with good occlusion， opening mouth well and good masticating. The x-ray examination proved that the coalescence of fracture was satisfactory. Conclusion Rigid internal fixation with titanium alloy plate is characterized by the advantages of easy operation， strong setting of fracture， good recovery of oral function postoperative and easy nursing for oral health. The nasal endotracheal intubation should not be applied to those patients with multiple line fracture of maxilla and craniocerebral trauma， while the effect of intermaxillary elastic traction therapy with dental arch splint is satisfied. 　　[Key words] Jaw bone fracture； Rigid internal fixation； Occlusal relationship； Intermaxillary elastic traction 　　口腔颌面部外伤造成的颌骨骨折呈逐年上升的趋势。颌骨骨折有一般骨折的共性，如出血、肿胀、疼痛、骨折移位、感觉异常和功能障碍等。但由于颌骨解剖结构和生理特点的特点，其临床表现和诊治方法与身体其它部位骨折又有所不同。下颌骨有较强大的升颌肌群和降颌肌群附