【摘要】：目的:探討影響兒童下頜骨髁突囊內(nèi)骨折治療方法選擇的因素,并對(duì)手術(shù)和保守療法的臨床效果及影像學(xué)k表現(xiàn)進(jìn)行對(duì)比。方法:對(duì)新疆醫(yī)科大學(xué)一附院2008年1月至2013年10月經(jīng)曲面斷層片、冠狀CT等確診為囊內(nèi)骨折的住院及門診患者78例103側(cè)進(jìn)行分類,并對(duì)所有患者均行MRI檢查確定關(guān)節(jié)盤的損傷及移位情況。對(duì)治療后的患者行臨床及影像學(xué)隨訪1~3年,評(píng)價(jià)其愈后療效。結(jié)果:影像學(xué)檢查:手術(shù)組髁突完全重建率為78.9%;保守組為72.4%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);手術(shù)組下頜骨對(duì)稱率為93.1%;保守組為80.0%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);臨床檢查:手術(shù)組并發(fā)癥少于保守組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩種治療方式對(duì)于髁突囊內(nèi)骨折愈后髁突改建及功能恢復(fù)均具有較高治愈率。結(jié)論:經(jīng)臨床驗(yàn)證:1)下頜支高度有無(wú)明顯縮短;2)關(guān)節(jié)盤有無(wú)損傷及移位;3)有無(wú)明顯張口受限及咬合紊亂;4)是否伴翼外肌附著喪失;以上幾方面對(duì)于兒童髁突囊內(nèi)骨折治療方式的選擇具有重要影響。
[Abstract]:Objective: to investigate the factors influencing the treatment of mandibular condylar fracture in children, and to compare the clinical effects and imaging k manifestations of surgical and conservative therapy. Methods: from January 2008 to October 2013, 103 sides of 78 in-patient and out-patient patients with intracapsular fractures diagnosed by coronal CT were classified, from January 2008 to October 2013, in the first affiliated Hospital of Xinjiang Medical University. All patients were examined with MRI to determine the injury and displacement of the articular disc. The patients were followed up for 1 ~ 3 years, and the curative effect was evaluated. Results: imaging examination: the complete condylar reconstruction rate was 78.9 in the operation group, 72.4 in the conservative group, with no statistical significance (P0.05); the mandibular symmetry rate was 93.1 in the operation group; 80.0in the conservative group, the difference was not statistically significant (P0.05); clinical examination: complications in the operation group were less than those in the conservative group. The difference was statistically significant (P0.05). The two treatments have a high cure rate for condylar reconstruction and functional recovery after recovery of intracapsular condylar fracture. Conclusion: it is clinically proved whether the height of mandibular branch is significantly shortened or not (2) the joint disc is injured and displaced. 3) there is no obvious limitation of opening and occlusal disorder (4) whether the attachment of the lateral pterygoid muscle is lost in addition to the attachment of the lateral pterygoid muscle. The above aspects have important influence on the choice of treatment methods for intracapsular fracture of condylar process in children.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.4

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