摘要
目的探讨唑来膦酸联合手术治疗颌骨骨折的疗效及对患者口腔功能恢复和骨代谢的影响。方法选取2016年2月至2018年1月广元市第一人民医院口腔科收治的50例颌骨骨折患者,根据治疗方法不同分为对照组(钛板内固定术治疗,22例)和观察组(唑来膦酸联合钛板内固定术治疗,28例)。比较两组的临床疗效,治疗前后Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、骨特异性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP)、骨钙素(OCN)水平以及口腔功能恢复、生活质量变化和不良反应发生率。结果治疗后观察组总有效率高于对照组[96.43%(27/28)比77.27%(17/22)](P<0.05)。治疗前后β-CTX、BALP、TRACP、OCN水平的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间β-CTX、BALP、TRACP、OCN水平的主效应差异有统计学意义(P<0.01);β-CTX的组间与时点间存在交互作用(P<0.05),BALP、TRACP、OCN无交互作用(P>0.05)。治疗后观察组开口度优于对照组,咬合关系、颞颌关节功能良好率高于对照组(P<0.05)。治疗前后心理功能、社会功能、物质生活、躯体功能评分的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间心理功能、社会功能、物质生活、躯体功能评分的主效应差异有统计学意义(P<0.05或P<0.01);心理功能、躯体功能评分的组间与时点间存在交互作用,社会功能、物质生活评分无交互作用(P>0.05)。治疗期间观察组总不良反应发生率明显低于对照组(P<0.05)。结论唑来膦酸联合手术治疗颌骨骨折的疗效显著,可调节骨代谢水平、促进口腔功能恢复,且不良反应较少,有助于提高患者生活质量。
Objective To investigate the effect of zoledronic acid combined with surgery in the treatment of jaw fracture and its effect on oral function recovery and bone metabolism.Methods A total of 50 patients with jaw fracture in the Department of Stomatology of Guangyuan First People′s Hospital from Feb.2016 to Jan.2018 were included and divided into a control group(titanium plate internal fixation,22 cases)and an observation group(zoledronic acid combined with titanium plate internal fixation,28 cases)according to the treatment method.The clinical effects of the two groups were compared,theβC-terminal cross-linked telopeptides of typeⅠcollagen(β-CTX),bone specific alkaline phosphatase(BALP),tartrate resistant acid phosphatase(TRACP),osteocalcin(OCN)levels before and after treatment,oral function recovery,quality of life changes and the incidence of adverse reactions of the two groups were compared.Results After treatment,the total effective rate of the observation group was higher than that of the control group[96.43%(27/28)vs 77.27%(17/22)](P<0.05).Before and after treatment the main effects ofβ-CTX,BALP,TRACP and OCN were statistically significant(P<0.01);regardless of the measurement time,there were significant differences between the two groups inβ-CTX,BALP,TRACP and OCN(P<0.01);there was interactioninβ-CTX between groups and time points(P<0.05),but no interactions in BALP,TRACP and OCN(P>0.05).After treatment,the opening degree of the observation group was better than that of the control group,and the good rates of jaw biting relationship and temporomandibular joint function of the observation group were higher than those of the control group(P<0.05).The main effects of psychological function,social function,material life and physical function scores before and after treatment were statistically significantly different(P<0.01);regardless of the measurement time,there were significant differences in the main effects of psychological function,social function,material life and physical function between the two groups(P<0.05 or P<0.01);there were interactions in the scores of psychological function and physical function,but no interactiosn in the scores of social function and material life between groups and time points(P>0.05).The incidence of total adverse reactions in the observation group was significantly lower than that in the control group during treatment(P<0.05).Conclusion Zoledronic acid combined with surgery in the treatment of jaw fracture has significant effect,which can adjust the level of bone metabolism,promote the recovery of oral function,and has less adverse reactions,thus helps to improve the quality of life of the patients.
作者
李鹏
杨军成
刘广毅
何福江
LI Peng;YANG Juncheng;LIU Guangyi;HE Fujiang(Department of Stomatology,Guangyuan First People′s Hospital,Guangyuan 628017,China)
出处
《医学综述》
CAS
2021年第16期3318-3323,共6页
Medical Recapitulate
关键词
颌骨骨折
唑来膦酸
钛板内固定
口腔功能
骨代谢
Jaw fracture
Zoledronic acid
Titanium plate internal Fixation
Oral function
Bone metabolism
