本文選題：頜骨囊腫 + 富自體纖維蛋白凝膠��； 參考：《山東大學》2017年碩士論文

【摘要】：目的探討CGF(concentrate growth factors,濃縮生長因子)聯(lián)合骨生成材料和口腔生物膜應用在頜骨囊腫術后骨缺損區(qū),察看其與單純依靠自體血機化修復的療效比較,為臨床治療頜骨囊性病變做出指導。方法(1)選取山東大學口腔醫(yī)院口腔頜面外科2014年7月-2016年10月間的頜骨囊性病變患者,共25例為實驗組,患者知情同意下,于頜骨囊性病變手術后行CGF+骨粉+生物膜治療。同時期選取25例頜骨囊腫病例作為對照組,患者知情同意下,只行頜骨囊性病變手術。實驗組及對照組共計50例病例,年齡16-60歲,完全隨機選擇,無年齡及性別特殊性。(2)手術方法:50例患者手術前均需拍攝全口曲面斷層片或口腔錐形束CT。并行頜骨囊性手術,實驗組抽取患者自身靜脈血,經(jīng)差速離心13min后制取CGF,將CGF用無菌剪剪成直徑約1mm顆粒與bio-oss骨粉混合,待囊腫摘除后骨腔內(nèi)填充CGF+骨粉混合物,表面覆蓋一人工生物膜,將其覆蓋在骨創(chuàng)緣約2-3mm處的健康骨質(zhì)上,嚴密縫合傷口。對照組在囊腫摘除術后囊腔內(nèi)不置入CGF和bio-oss骨粉,也不放置人工生物膜。術后應用抗生素3d,益口含漱液漱口,10-12天拆線。在頜骨囊腫摘除術后3個月和半年復診,并在同樣的參數(shù)和同樣的照射條件下拍攝CBCT。(3)影像學分析:①使用Adobe Photoshop對全口曲面斷層片和錐形束CT的骨缺損區(qū)影像進行灰度值測量。CBCT選取病變最長徑時的矢狀面,冠狀面,橫斷面為測量平面。每個圖像測量空白區(qū)的灰度值和骨缺損區(qū)灰度值,兩數(shù)相減即為骨缺損區(qū)的實際灰度值。每個圖像測量3次,取3次平均數(shù)值為準。②測量實驗組和對照組骨缺損區(qū)范圍的變化。調(diào)整骨缺損區(qū)CBCT的矢狀面,冠狀面和橫斷面,測量按標準劃定的骨缺損區(qū)實驗組和對照組3個月和6個月時的垂直長度和水平長度。比較實驗組和對照組相同切面(例如同時都是矢狀面)的垂直線和水平線的平均長度。與手術前比較,差距越大的表明成骨越快。為避免誤差,每個數(shù)據(jù)由同一人測量三次,取其平均值。(4)統(tǒng)計學分析:使用spss17.0統(tǒng)計軟件分析,所有影像學的測量數(shù)據(jù)采用t檢驗。兩組性別,囊腫部位,囊腫類型的比較采用卡方檢驗,年齡與囊腫大小采用非參數(shù)秩和檢驗。檢驗水準為雙側(cè)α =0.05,p0.05表示差異具有統(tǒng)計學意義。結(jié)果臨床資料分析:經(jīng)統(tǒng)計學分析,實驗組和對照組在性別,年齡,囊腫部位,囊腫類型和囊腫面積方面均無顯著差異(p0.05)。(1)曲面斷層片分析頜骨囊腫術后3個月,對照組曲面斷層片骨缺損區(qū)平均灰度值為15.86±2.70,實驗組平均灰度值為84.34±2.97;對照組小于實驗組,但經(jīng)統(tǒng)計學分析,p0.05,兩組比較具有顯著差異。術后6個月,對照組為36.39±3.86,實驗組為90.88±2.44,對照組顯著小于實驗組,經(jīng)統(tǒng)計學分析p0.05,二者比較有顯著差異。(2)CBCT不同切面灰度值的分析①冠狀面CBCT:術后3個月,對照組CBCT骨缺損區(qū)的平均灰度值為17.83 ±2.96,實驗組的平均灰度值為86.91±2.94,對照組低于實驗組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異;術后6個月,對照組的平均灰度值為37.01 ±2.35,實驗組的平均灰度值為91.58±2.96,對照組低于實驗組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異。②矢狀面CBCT:術后3個月,對照組CBCT骨缺損區(qū)的平均灰度值為16.48±2.85,實驗組的平均灰度值為84.91±3.91,實驗組高于對照組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異。術后6個月,對照組的平均灰度值為35.87±2.41,實驗組的平均灰度值為90.75±2.85,實驗組高于對照組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異。③橫斷面CBCT:術后3個月,對照組骨缺損區(qū)的平均灰度值為16.34±3.46,實驗組的為85.01±2.73,實驗組高于對照組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異。術后6個月,對照組的平均灰度值為91.76±2.81,實驗組的為91.76±2.81,實驗組高于對照組,經(jīng)統(tǒng)計學分析,p0.05,二者比較具有顯著差異。(3)CBCT不同切面垂直長度和水平長度差值平均值的分析①冠狀面CBCT:手術前實驗組平均垂直長度為19.49±2.21mm,對照組為19.63±2.34mm,t值為-0.770,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均垂直長度為17.15±2.66mm,對照組為19.23士3.05mm,t值為-26.732,p0.05,二者比較具有顯著差異。術后六個月實驗組平均垂直長度為15.31±3.37mm,對照組為18.23±3.19mm,t值為-21.236,p0.05,二者比較具有顯著差異。手術前實驗組平均水平長度為17.65士2.06mm,對照組為17.85±2.31mm,t值為-0.859,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均水平長度為15.33±2.22mm,對照組為17.46±3.58mm,t值為-26.532,p0.05,二者比較具有顯著差異。術后六個月實驗組平均水平長度為13.27±3.56mm,對照組為16.13±3.59mm,t值為-24.937,p0.05,二者比較具有顯著差異。②矢狀面CBCT:手術前實驗組平均垂直長度為19.45±2.06mm,對照組為19.18±2.47mm,t值為5.091,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均垂直長度為17.50±2.85mm,對照組為18.23±3.02mm,t值為-36.634,p0.05,二者比較具有顯著差異。術后六個月實驗組平均垂直長度為16.52±3.44mm,對照組為 17.95±3.20mm,t 值為-31.389,p0.05,二者比較具有顯著差異。手術前實驗組平均水平長度為17.45±2.06mm,對照組為17.65±2.47mm,t值為-0.862,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均水平長度為16.08±2.66mm,對照組為17.23±3.05mm,t值為-32.388,p0.05,二者比較具有顯著差異。術后六個月實驗組平均水平長度為14.31±3.37mm,對照組為16.23±3.19mm,t值為-27.628,p0.05,二者比較具有顯著差異。③橫斷面CBCT:手術前實驗組平均垂直長度為12.49±2.32mm,對照組為12.63±2.51mm,t值為-0.789,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均垂直長度為10.52±2.44mm,對照組為12.01±3.03mm,t值為-29.327mm,p0.05,二者比較具有顯著差異。術后六個月實驗組平均垂直長度為9.31±3.43mm,對照組為11.25±3.21mm,t值為-27.005,p0.05,二者比較具有顯著差異。手術前實驗組平均水平長度為13.52±2.14mm,對照組為13.65±2.31mm,t值為-0.715,p0.05,二者比較沒有顯著差異。術后三個月實驗組平均水平長度為11.37士2.23mm,對照組為 12.86±3.54mm,t 值為-29.529,p0.05,二者比較具有顯著差異。術后六個月實驗組平均水平長度為9.58±3.66mm,對照組為11.13±3.44mm,t值為-29.899,p0.05,二者比較具有顯著差異。結(jié)論本實驗表明CGF聯(lián)合引導骨組織再生技術對成骨有促進作用,而且比單純依靠血液機化效果更顯著,骨缺損區(qū)成骨速度更快,更有利于組織愈合及后期修復功能的恢復。
[Abstract]:Objective to investigate the application of CGF (concentrate growth factors, concentrated growth factor) combined with bone formation material and oral biofilm in the bone defect area after maxillofacial cyst operation, and to observe the comparison of the curative effect compared with the simple autologous blood machine repair. Method (1) select the oral and maxillofacial surface of the Shandong University stomatological hospital. A total of 25 cases of maxillofacial cystic lesions between July 2014 -2016 and October were treated as experimental group. Patients were treated with CGF+ bone powder plus biomembrane after informed consent. At the same time, 25 cases of maxillofacial cysts were selected as the control group. The patient's informed consent was performed only with the operation of maxillary cystic lesions. The total of the experimental group and the control group were 5. 0 cases, aged 16-60 years, were randomly selected, without age and sex particularity. (2) surgical methods: 50 patients were required to take full oral surface tomography or oral conical beam CT. parallel maxillofacial operation before operation. The experimental group took the patient's own venous blood, then made CGF after the differential 13min, and cut the CGF with a diameter of about 1mm. The granules were mixed with Bio-Oss bone powder. After the cyst was removed, the CGF+ bone powder mixture was filled in the bone cavity. The surface was covered with an artificial biofilm, covering it on the healthy bone of the bone margin of about 2-3mm, and suturing the wound closely. The control group did not put in the CGF and Bio-Oss bone powder in the capsule after the cyst extirpation, and no artificial biofilm was placed. After the operation, the antibiosis was applied. 3D, yitkou gargle, rinse the mouth for 10-12 days. 3 months and half a year after the removal of the jaw cyst, and take the CBCT. (3) imaging analysis under the same parameters and the same irradiation conditions: (1) the gray value measurement of the image of the bone defect area of the full oral surface fault and the conical bundle CT was measured by the Adobe Photoshop, and the length of the lesion was measured by the gray value. The sagittal plane, the coronal plane and the cross section of the diameter were measured. Each image measured the gray value of the blank area and the gray value of the bone defect area. The reduction of the two numbers was the actual gray value of the bone defect area. Each image was measured 3 times, and the average value of the 3 times was measured. 2. The changes in the bone defect area of the experimental and control groups were measured. The CBCT of the bone defect area was adjusted. Sagittal, coronal, and cross sections were used to measure the vertical length and horizontal length of the experimental group and the control group for 3 months and 6 months. The average length of the vertical and horizontal lines of the same section (such as the sagittal plane) was compared between the experimental group and the control group. The larger the gap was, the greater the difference between the experimental group and the control group. Fast. In order to avoid error, each data was measured by the same person three times, taking its average value. (4) statistical analysis: using SPSS17.0 statistical software analysis, all imaging data were measured by t test. Two groups of sex, cyst site, cyst type were compared with chi square test, age and cyst size using nonparametric rank sum test. Test level was Bilateral alpha =0.05 and P0.05 showed statistical significance. Results clinical data analysis: statistical analysis showed that there was no significant difference between the experimental group and the control group in sex, age, cyst site, cyst type and cyst area (P0.05). (1) 3 months after maxillofacial cysts analysis, and the bone defect of the control group, Qu Ping The average gray value is 15.86 + 2.70, the average gray value of the experimental group is 84.34 + 2.97, the control group is less than the experimental group, but the statistical analysis, P0.05, the two groups have significant differences. 6 months after the operation, the control group is 36.39 + 3.86, the experimental group is 90.88 + 2.44, the control group is significantly smaller than the experimental group, statistically analyzed by P0.05, there are significant differences. (2) C BCT analysis of the gray value of different cutting surfaces (1) after 3 months of coronary CBCT:, the average gray value of the CBCT bone defect area of the control group was 17.83 + 2.96, the average gray value of the experimental group was 86.91 + 2.94, the control group was lower than the experimental group. The comparison between the P0.05 and the two groups was significantly different, and the average gray value of the control group was 37.01 + 2 after 6 months after the operation. .35, the average gray value of the experimental group was 91.58 + 2.96, the control group was lower than the experimental group. The statistical analysis showed that the average gray value of the CBCT bone defect area of the control group was 16.48 + 2.85, the average gray value of the control group was 84.91 + 2.85, and the experimental group was higher than the control group for 3 months after CBCT:, and the experimental group was higher than the control group. The average gray value of the control group was 35.87 + 2.41, the average gray value of the experimental group was 90.75 + 2.85, and the experimental group was higher than the control group at 6 months after the operation. The average gray value of the experimental group was higher than that of the control group. The average gray value of the bone defect area of the control group was 16.34 after the statistical analysis, P0.05 and two were significantly different. ((3) the average gray value of the bone defect area in the control group was 16.34. The average gray value of the control group was 16.34, and the average gray value of the control group was 90.75 + 2.85. The average gray value of the experimental group was 90.75 + 2.85. The average gray value of the bone defect area in the control group was 16.34. (3) the average gray value of the control group was 16.34. (3) the average gray value of the bone defect area of the control group was 16.34. (3) the average gray value of the two groups was 16.34. 3.46, the experimental group was 85.01 + 2.73, the experimental group was higher than the control group. The statistical analysis showed that the P0.05 and the two were significantly different. The average gray value of the control group was 91.76 + 2.81 after 6 months of operation. The experimental group was 91.76 + 2.81, the experimental group was higher than the control group. The statistical analysis showed that there were significant differences in P0.05 and two. (3) different sections of CBCT The average vertical length and the horizontal length difference mean value of the average vertical length of the experimental group before CBCT: operation was 19.49 + 2.21mm, the control group was 19.63 + 2.34mm, the T value was -0.770, P0.05, there was no significant difference between the two groups. The average vertical length of the experimental group was 17.15 + 2.66mm, the control group was 19.23 3.05mm, and the T value was -26.732 in the three months after the operation. P0.05, the comparison of the two was significant. The average vertical length of the experimental group was 15.31 + 3.37mm, the control group was 18.23 + 3.19mm, the T value was -21.236, P0.05, and the two were significantly different. The average length of the experimental group was 17.65 2.06mm, the control group was 17.85 + 2.31mm, the T value was -0.859, P0.05, the two were not significant. The average horizontal length of the three months after the operation was 15.33 + 2.22mm, the control group was 17.46 + 3.58mm, the T value was -26.532, and the two were significantly different. The average level of the experimental group was 13.27 + 3.56mm, the control group was 16.13 + 3.59mm, t value was -24.937, P0.05, and two had significant differences. Second, sagittal plane CBCT:. The average vertical length of the experimental group was 19.45 + 2.06mm, the control group was 19.18 + 2.47mm, the T value was 5.091, and the two had no significant difference. The average vertical length of the experimental group was 17.50 + 2.85mm, the control group was 18.23 + 3.02mm, the T value was -36.634, and the two of the experimental group had significant difference. The average drooping of the experimental group was six months after the operation. The direct length was 16.52 + 3.44mm, the control group was 17.95 + 3.20mm, the T value was -31.389 and P0.05. The average level of the experimental group before operation was 17.45 + 2.06mm, the control group was 17.65 + 2.47mm, t value was -0.862, P0.05, and there was no significant difference. The average level of the experimental group was 16.08 + 2.66mm in three months after the operation. The group was 17.23 + 3.05mm, and the value of T was -32.388 and P0.05. The comparison of the two were significantly different. The average length of the experimental group was 14.31 + 3.37mm, the control group was 16.23 + 3.19mm, the T value was -27.628, and the two had significant difference. (3) the average vertical length of the test group in the cross section was 12.49 + 2.32mm, and the control group was 12.63. Three months after operation, the average vertical length of the experimental group was 10.52 + 2.44mm, the control group was 12.01 + 3.03mm, the T value was -29.327mm, and the two of the two had significant differences. The average vertical length of the experimental group was 9.31 + 3.43mm and the control group was 11.25 + 3.21mm and t values were 11.25 after three months after the operation. 0.05, the comparison of the two was significant. The average length of the experimental group was 13.52 + 2.14mm, the control group was 13.65 + 2.31mm, the T value was -0.715, and the two had no significant difference. The average length of the experimental group was 11.37 2.23mm, the control group was 12.86 + 3.54mm, t value was -29.529, P0.05, and the two were more significant. The average length of the experimental group was 9.58 + 3.66mm, the control group was 11.13 + 3.44mm, the T value was -29.899, and the two of the two were significantly different. Conclusion this experiment showed that the combination of CGF and bone tissue regeneration could promote the osteogenesis, and was more significant than the effect of blood machine, and the osteogenesis speed of the bone defect area was more significant. Faster, more conducive to tissue healing and restoration of functional recovery later.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R782

【相似文獻】

相關期刊論文 前1條

1 稅典奎;陳峭;侯秋科;;不同劑量甘草煎劑對大鼠胃電活動、胃竇組織中5-羥色胺攝取和脫羧細胞的數(shù)目、面積及平均灰度值的影響[J];湖北中醫(yī)藥大學學報;2014年04期

相關碩士學位論文 前1條

1 吳學敏;CGF聯(lián)合引導骨組織再生術在頜骨囊性病變治療中的療效觀察[D];山東大學;2017年

，

本文編號：1974773