节段设计原则在小切口入路坚固内固定治疗颌面部骨折的应用

摘要

Objective To explore the application effects of segmental design principles in the small incision approach rigid internal fixation for the treatment of maxillofacial fractures.Methods With a retrospective study,from September 2012 to April 2016,172 patients with maxillofacial fractures were selected as the research object in our hospital.All the patients were divided into the observation group of 100 patients and control group of patients according to the different treatment methods.Two groups were treated with mall incision approach rigid internal fixation.The observation group were given the preoperative design based on the segmental design principles.The other operation process were similar with the control group.Results All patients were completed the operation,the fracture were healed by Ⅰ stage.The postoperative 3months of total effective rates of the observation group and the control group were 98.0％ and 83.3％.The total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The postoperative 3months of infection,nerve injury,salivary fistula,screw loosening and complication rate in the observation group was 3.0％,so that was 20.8％ in the control group,the observation group was significantly lower than the control group (P ＜ 0.05).The postoperative 3months of occlusal relationship and normal rates of the observation group were 99.0％ and 98.0％,respectively.The control group was 93.1％and 90.3％,respectively.There were between the two groups statistically significance difference(P ＜ 0.05).Conclusion The segmental design principles in the small incision approach rigid internal fixation for the treatment of maxillofacial fractures can improve the therapeutic effect,reduce the incidence of postoperative complications,improve the occlusal relationship with normal mouth opening rate.It is an ideal method for the treatment of maxillofacial fracture.%目的 探讨节段设计原则在小切口入路坚固内固定治疗颌面部骨折的应用效果.方法 采用回顾性研究方法,选择2012年9月～2016年4月在笔者医院诊治的颌面部骨折患者172例作为研究对象,根据治疗方法的不同分为观察组100例与对照组72例,两组都给予小切口入路坚固内固定治疗,观察组在术前设计中遵循节段设计原则,其他手术过程同对照组.结果 所有患者均完成手术,骨折均为Ⅰ期愈合;术后3个月,在总有效率上,观察组达到98.0％,对照组达到83.3％,观察组明显高于对照组(P＜0.05).观察组术后3个月的感染、面神经损伤、涎瘘、螺钉松动等并发症发生率为3.0％,对照组为20.8％,观察组明显低于对照组(P＜0.05).观察组咬合关系与张口正常率分别为99.0％和98.0％,对照组为93.1％和90.3％,两两比较差异均有统计学意义(P＜0.05).结论 节段设计原则在小切口入路坚固内固定治疗颌面部骨折的应用具有很高的成功率,能提高治疗效果,减少术后并发症的发生,提高咬合关系与张口正常率,是治疗颌面部骨折较理想的方法.