颅颌面骨折及伴发伤同期手术的临床研究

发布时间：2018-08-09 20:20

【摘要】：目的比较颅颌面部骨折有全身伴发伤患者同期手术及分期手术的治疗效果。方法将颅颌面部骨折伴有其他部位创伤患者50例,随机分为同期手术组(28例)和分期手术组(22例)。同期手术组采取相关科室联合同期为患者行颌面部骨折复位内固定术及其他部位手术,分期手术组在伴发伤治疗结束后再进行颌面部骨折复位内固定术。对2组的治疗效果及并发症等进行比较分析。结果同期手术组术后咬合正常26例,张口度(34.5±3.7)mm,术后颌面部硬组织对称性及外形恢复良好,1例因内固定感染取出接骨板。分期手术组术后咬合正常14例,张口度(28.5±3.5)mm,术后颌面部硬组织对称性及外形恢复较差,5例因内固定感染取出接骨板。2组的咬合关系、张口度、术后并发症、住院时间等之间的差异均有统计学意义(P0.05),同期手术组的治疗效果优于分期手术组。结论在患者全身条件许可的情况下,对颅颌面部骨折伴有其他部位伤的患者应尽量采取多学科同期手术治疗。
[Abstract]:Objective to compare the effect of simultaneous operation and staged operation in patients with craniomaxillofacial fractures with systemic injuries. Methods 50 patients with craniomaxillofacial fractures associated with other trauma were randomly divided into two groups: the simultaneous operation group (28 cases) and the staging operation group (22 cases). At the same time, the patients in the operation group received reduction and internal fixation of maxillofacial fractures at the same time, and the patients in the staging group were treated with reduction and internal fixation of maxillofacial fractures after the treatment of associated injuries. The therapeutic effects and complications of the two groups were compared and analyzed. Results in the operation group, the occlusal was normal in 26 cases and the opening degree was (34.5 卤3.7) mm. After operation, the symmetry and shape of the maxillofacial hard tissue recovered well. One case was removed from the bone plate because of the infection of internal fixation. In the staging group, 14 cases had normal occlusal, the opening degree was (28.5 卤3.5) mm, and the symmetry and shape of the maxillofacial hard tissue recovered badly after operation. 5 cases were removed the occlusion relation, opening degree and postoperative complication of the bone plate group .2 because of the infection of internal fixation. The difference of hospitalization time was statistically significant (P0.05). The therapeutic effect of the operation group was better than that of the staged operation group at the same time. Conclusion the patients with craniomaxillofacial fractures with other injuries should be treated with multi-disciplinary simultaneous operation as far as possible.
【作者单位】：南京医科大学附属淮安第一医院口腔科;口腔疾病研究国家重点实验室华西口腔医院创伤整形外科(四川大学);
【分类号】：R782.4

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