儿童髁突囊内骨折不同治疗方式后疗效及影响因素分析

发布时间：2018-07-14 20:34

【摘要】：目的:探讨影响儿童下颌骨髁突囊内骨折治疗方法选择的因素,并对手术和保守疗法的临床效果及影像学k表现进行对比。方法:对新疆医科大学一附院2008年1月至2013年10月经曲面断层片、冠状CT等确诊为囊内骨折的住院及门诊患者78例103侧进行分类,并对所有患者均行MRI检查确定关节盘的损伤及移位情况。对治疗后的患者行临床及影像学随访1~3年,评价其愈后疗效。结果:影像学检查:手术组髁突完全重建率为78.9%;保守组为72.4%,差异无统计学意义(P0.05);手术组下颌骨对称率为93.1%;保守组为80.0%,差异无统计学意义(P0.05);临床检查:手术组并发症少于保守组,差异有统计学意义(P0.05)。两种治疗方式对于髁突囊内骨折愈后髁突改建及功能恢复均具有较高治愈率。结论:经临床验证:1)下颌支高度有无明显缩短;2)关节盘有无损伤及移位;3)有无明显张口受限及咬合紊乱;4)是否伴翼外肌附着丧失;以上几方面对于儿童髁突囊内骨折治疗方式的选择具有重要影响。
[Abstract]:Objective: to investigate the factors influencing the treatment of mandibular condylar fracture in children, and to compare the clinical effects and imaging k manifestations of surgical and conservative therapy. Methods: from January 2008 to October 2013, 103 sides of 78 in-patient and out-patient patients with intracapsular fractures diagnosed by coronal CT were classified, from January 2008 to October 2013, in the first affiliated Hospital of Xinjiang Medical University. All patients were examined with MRI to determine the injury and displacement of the articular disc. The patients were followed up for 1 ~ 3 years, and the curative effect was evaluated. Results: imaging examination: the complete condylar reconstruction rate was 78.9 in the operation group, 72.4 in the conservative group, with no statistical significance (P0.05); the mandibular symmetry rate was 93.1 in the operation group; 80.0in the conservative group, the difference was not statistically significant (P0.05); clinical examination: complications in the operation group were less than those in the conservative group. The difference was statistically significant (P0.05). The two treatments have a high cure rate for condylar reconstruction and functional recovery after recovery of intracapsular condylar fracture. Conclusion: it is clinically proved whether the height of mandibular branch is significantly shortened or not (2) the joint disc is injured and displaced. 3) there is no obvious limitation of opening and occlusal disorder (4) whether the attachment of the lateral pterygoid muscle is lost in addition to the attachment of the lateral pterygoid muscle. The above aspects have important influence on the choice of treatment methods for intracapsular fracture of condylar process in children.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.4

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