目的: 探讨关节上腔注射透明质酸钠凝胶联合佩戴Twin-block垫治疗颞下颌关节(TMJ) 弹响的临床效果.方法:纳入颞下颌关节弹响的患者60名,分为3组,每组20名.第一组采用关节上腔注射透明质酸钠凝胶(1次/2周,共3次) 联合佩戴Twin-block垫治疗(12 h /d,共3个月);第二组采用单纯佩戴Twin-block垫治疗.第三组采用单纯透明质酸钠凝胶关节上腔注射法治疗;采用医师与患者共同参与法对3组患者治疗前后关节区弹响变化情况进行评价.结果: 第一组总有效率95％,治疗后弹响症状消失或明显改善.第二组总有效率85％,治疗后弹响症状改善.第三组总有效率65％,治疗后弹响症状有所改善.3组临床疗效比较P ＜ 0. 05.结论: 采用关节上腔注射透明质酸钠凝胶联合佩戴Twin-block垫治疗TMJ弹响的疗效优于单纯佩戴Twin-block垫治疗或单纯注射透明质酸钠凝胶治疗.%Objective: To observe the clinical effects of upper articular cavity injection with hyaluronate(HA) combined with Twinblock in the treatment of temporomandibular joint(TMJ) clicks. Methods: 60 patients with TMJ clicks were divided into 3 groups(n = 20) and were treated by articular cavity injection combined with Twin-block(group 1),Twin-block only(group 2) and injection of sodium hyaluronate gel(group 3) respectively. The effects were evaluated and compared before and after treatment by both doctors and patients. Results: The effective rate of group 1,2 and 3 was 95％,and 65％ respectively(P ＜ 0. 05). After treatment the TMJ clicks were almost dispeared in group 1,remitted in group 2 and slightly remitted in group 3. Conclusion: The articular cavity injection of HA combined with Twin-block is more effective in the treatment of TMJ clicks than Twin-block or articular cavity injection of HA.
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