【摘要】：目的：本文以病例報告的形式，探討牙齦瘤的病理分型、臨床特點、手術方法及愈合修復的臨床體會。 方法：收集臨床病例診斷為牙齦瘤的患者16例，其中15例為首發(fā)，1例為復發(fā)后首診。所有患者經局部齦上、齦下潔刮治、根面平整術一周后，局麻下手術切除，手術按牙齦瘤的大小及生長位置分為單純瘤體切除和瘤體切除結合結締組織瓣修復，后者術中為覆蓋創(chuàng)面所采用的結締組織瓣包括：鄰接組織單側或雙側半厚瓣滑行移位修復、根向復位及游離齦瓣復位。組織切除后送檢病理，按病理分型分成纖維性齦瘤、血管性齦瘤、巨細胞性齦瘤三組。術后一周，觀察手術創(chuàng)面愈合情況，有無術后疼痛及腫脹等并發(fā)癥，牙齦緣位置是否穩(wěn)定，有無退縮，牙齦的顏色形態(tài)是否恢復正常及牙周組織愈合效果等。遠期觀察復發(fā)率。 結果：16例患者中，纖維性齦瘤9例（56.2%），血管性齦瘤6例（37.5%），，外周巨細胞性齦瘤1例（6.25%）。術后對16例牙齦瘤患者進行6~18個月的隨訪，無1例復發(fā)。術區(qū)創(chuàng)面愈合良好，牙齦緣位置穩(wěn)定，牙齦的色澤和外形恢復正常，無明顯的疼痛、腫脹及瘢痕等并發(fā)癥。 結論：牙齦瘤有三種病理分型，每種病理分型有其各自的臨床表現(xiàn)及組織學特點，病理分型與復發(fā)率之間無明顯相關性。牙齦瘤的治療原則是徹底切除瘤體、去除局部刺激因素及防止復發(fā)。手術方法因能對術區(qū)進行結締組織瓣修復且術后創(chuàng)面愈合良好，膜齦位置穩(wěn)定，并發(fā)癥少，是治療牙齦瘤的合理方法之一。
[Abstract]:Objective: to study the pathological classification, clinical features, surgical methods and healing and repair of gingival tumor in the form of case report. Methods: 16 cases of gingival tumor were collected, of which 15 cases were first diagnosed after recurrence. All the patients were treated by local supragingival, subgingival cleaning and curettage. One week after root surface leveling, local anesthesia was performed. The operation was divided into simple tumor resection and tumor resection combined with connective tissue flap according to the size and growth location of gingival tumor. The connective tissue flap used to cover the wound in the latter operation included: unilateral or bilateral half-thick flap sliding repair, root reduction and free gingival flap reduction. Histopathological examination was performed and divided into three groups: fibrous gingival tumor, vascular gingival tumor and giant cell gingival tumor. One week after operation, the healing of surgical wound was observed, whether there were complications such as pain and swelling after operation, whether the position of gingival margin was stable, whether there was withdrawal, whether the color shape of gingiva returned to normal, and whether the effect of periodontal tissue healing was observed. Long-term observation of recurrence rate. Results among the 16 cases, 9 cases (56.2%) were fibroplastic gingival tumor, 6 cases (37.5%) were vascular gingival tumor, 1 case (6.25%) was peripheral giant cell gingival tumor. 16 cases of gingival tumor were followed up for 6 ~ 18 months, none of them recurred. The wound healed well, the position of gingival margin was stable, the color and appearance of gingival returned to normal, and there was no obvious pain, swelling, scar and other complications. Conclusion: there are three types of gingival neoplasms, each of which has its own clinical and histological features, and there is no significant correlation between pathological classification and recurrence rate. The treatment principle of gingival tumor is to remove local irritation factors and prevent recurrence. The operative method is one of the reasonable methods for the treatment of gingival tumor because it can be repaired by connective tissue flap and the wound healing is good the position of membranous gingiva is stable and the complications are few.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.8

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