单纯刮治术与开窗减压联合刮治术治疗牙源性颌骨囊肿的疗效比较

Comparison of the therapeutic effects of simple curettage and fenestration decompression combined curettage in the treatment of odontogenic jawbone cysts

摘要:

目的 比较单纯刮治术与开窗减压联合刮治术治疗牙源性颌骨囊肿的疗效。方法 回顾性选取2020年5月—2023年3月商洛市中心医院收治的81例牙源性颌骨囊肿患者，根据手术方法分为刮治组（43例）和联合组（38例）。刮治组予以单纯囊肿刮治术治疗，联合组予以开窗减压联合刮治术治疗。比较两组围手术期指标、疼痛程度、囊肿改善情况、并发症发生情况及复发率。结果 联合组手术时间和术中出血量均低于刮治组（P <0.05）。联合组术后3个月体积缩小量、术后6个月体积缩小量、术后3个月面积缩小量和术后6个月面积缩小量均高于刮治组（P <0.05），联合组囊肿愈合时间短于刮治组（P <0.05）。联合组术后3个月骨密度、术后6个月骨密度、术后3个月骨质增生厚度和术后6个月骨质增生厚度均高于刮治组（P <0.05）。刮治组与联合组术后3、5、7 d的VAS评分比较，不同时间点VAS评分比较，差异有统计学意义（P <0.05）；两组VAS评分比较，差异有统计学意义（P <0.05），联合组VAS评分较低，相对镇痛效果较好；两组VAS评分变化趋势比较，差异有统计学意义（P <0.05）。两组术后并发症发生率比较，差异无统计学意义（P >0.05）。两组复发率比较，差异有统计学意义（P <0.05），联合组低于刮治组。结论 开窗减压联合刮治术治疗牙源性颌骨囊肿的疗效优于单纯刮治术，能够缩短手术时间、减少术中出血量、减轻术后疼痛、缩短创口愈合时间，并降低囊肿复发率。

Abstract:

Objective To compare the efficacy of simple curettage and fenestration decompression combined curettage in the treatment of odontogenic jawbone cysts.Methods A retrospective study was conducted on 81 patients with odontogenic jawbone cysts in Shangluo Central Hospital from May 2020 to March 2023. They were divided into the curettage group (43 cases) and the combined group (38 cases) according to the surgical methods. The curettage group was treated with simple cyst curettage, while the combined group was treated with fenestration decompression combined with curettage. The perioperative indicators, pain degree, cyst improvement, occurrence of complications and recurrence rate of the two groups were compared.Results The operation time, intraoperative blood loss and cyst healing time of the combined group were all lower than those of the curettage group (P < 0.05). The reduction in cyst volume and area at 6 months after the operation in both groups was higher than that at 3 months after the operation, and the combined group was higher than the curettage group (P < 0.05). The thickness of bone hyperplasia and bone mineral density in both groups at 6 months after the operation were higher than those at 3 months after the operation, and the combined group was higher than the curettage group (P < 0.05). The visual analogue scale (VAS) scores of both groups gradually decreased after the operation, and the VAS scores of the combined group at 3, 5, and 7 days after the operation were all lower than those of the curettage group (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05). The difference in recurrence rates between the two groups was statistically significant (P < 0.05), the combined group was lower than the curettage group.Conclusion Compared with simple curettage, fenestration decompression combined with curettage in the treatment of odontogenic jawbone cysts can effectively promote cyst shrinkage, alleviate postoperative pain and reduce recurrence.