首页> 中文期刊> 《华西口腔医学杂志》 >颅颌面骨折及伴发伤同期手术的临床研究

颅颌面骨折及伴发伤同期手术的临床研究

         

摘要

Objective This study aimed to compare the treatment effects of simultaneous surgical treatment and stage ope-ration for patients with craniomaxillofacial fracture combined with other injuries. Methods Fifty patients with maxillofacial fractures combined with other injuries were chosen and divided into simultaneous (28 patients) and staging (22 patients) ope-ration groups. In simultaneous operation group, maxillofacial fracture reduction, internal fixation, and other parts of the surgery were simultaneously operated by relevant departments jointly. In the staging operation group, maxillofacial fracture reduction and internal fixation were performed after treatment of other injuries. Data on the treatment efficacy and associated injuries of the two groups were statistically analyzed. Results In the simultaneous operation group, 26 patients had good occluding relation, the maximum mouth opening was (34.5±3.7) mm, the symmetry and shape of hard tissues recovered well, and the bone plate of one patient was removed because of internal fixation infection. In the staging operation group, 14 patients had good occluding relation, the maximum mouth opening was (28.5±3.5) mm, the symmetry and shape of hard tissues poorly recovered, and the bone plates of 5 patients were removed because of internal fixation infection. Statistical significance was determined among occluding relation, maximum mouth opening, postoperative complications, and length of stay of the two groups (P<0.05). Treatment of the simultaneous operation group was more effective than that of the staging operation group. Conclusion When a patient’s condition is relatively stable, simultaneous surgical treatment of multiple specialties should be conducted to treat craniomaxillofacial fracture combined with other injuries.%目的: 比较颅颌面部骨折有全身伴发伤患者同期手术及分期手术的治疗效果。方法 将颅颌面部骨折伴有其他部位创伤患者50例,随机分为同期手术组(28例)和分期手术组(22例)。同期手术组采取相关科室联合同期为患者行颌面部骨折复位内固定术及其他部位手术,分期手术组在伴发伤治疗结束后再进行颌面部骨折复位内固定术。对2组的治疗效果及并发症等进行比较分析。结果 同期手术组术后咬合正常26例,张口度(34.5±3.7)mm,术后颌面部硬组织对称性及外形恢复良好,1例因内固定感染取出接骨板。分期手术组术后咬合正常14例,张口度(28.5±3.5)mm,术后颌面部硬组织对称性及外形恢复较差,5例因内固定感染取出接骨板。2组的咬合关系、张口度、术后并发症、住院时间等之间的差异均有统计学意义(P<0.05),同期手术组的治疗效果优于分期手术组。结论 在患者全身条件许可的情况下,对颅颌面部骨折伴有其他部位伤的患者应尽量采取多学科同期手术治疗。

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