穿颊器联合口内切口微创治疗下颌骨角部及升支骨折的临床应用

摘要

目的：探究分析利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折的临床应用及治疗效果。方法选取我院自2012年10月1日～2015年3月31日期间收治的下颌骨角部、升支骨折患者62例，作为临床研究对象。将所有患者进行随机分为对照组和观察组，每组各31例，对照组采用常规下颌下入路行骨折固定，观察组采用穿颊器联合口内切口入路微创治疗行骨折固定。对患者术后进行随访，记录并比较两组患者术后半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率及其临床疗效。结果观察组术后半年上下颌颌关系恢复情况明显优于对照组，其半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率（3.23％、0.00％、3.23％、6.45％）均明显小于对照组（29.03％、25.81％、32.26％、35.48％），且其手术显效率及总有效率（58.06％、90.32％）也均明显高于对照组（22.58％、29.03％），（ p＜0.05），差异具有统计学意义。结论利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折优势明显，手术创伤小，术后并发症少，患者颌关系恢复情况良好，有一定的临床优势，值得推广使用。%Objective To explore the clinical application and effect of wearing buccal apparatus combined with intraoral incision minimally invasive treatment of mandibular angle and rami fractures .Methods 62 patients of Mandibular angle and ramus fractures during the march month 31 from October 1, 2012 to 2015 in our hospital were selected as a clinical research object .All the patients were grouped randomly with 31 cases in each group .The con-trol group was treated with conventional submandibular approach for fracture fixation , and the observation group were treated by wearing buccal apparatus combined with intraoral incision minimally invasive treatment for bone fracture fixation.The patients were followed up after operation , and half patients were compared faciocervical scar , trismus, parotid salivary fistula , facial nerve injury and other complications occurrence rate and clinical efficacy between the two groups .Results The patients in the observation group after six months on the mandibular jaw relation restoration is significantly better than the control group , and the half facial and neck scar , trismus, parotid salivary fistula, facial nerve injury complication rate (3.23%, 0.00%, 3.23%, 6.45%) was significantly lower than that of control group (29.03%, 25.81%, 32.26%, 35.48%); The operation marked effective rate and total effective rate (58.06%, 90.32%) were obviously higher than those of the control group patients (22.58%, 29.03%)(p<0.05).Conclu-sion Wear buccal apparatus combined with intraoral incision minimally invasive treatment of mandibular angle and Rami fractures has obvious advantage , including small surgical trauma , less postoperative complications and well re-covered jaw relation .It has certain clinical advantages , and is worthy to be popularized .