关节灌洗术并透明质酸钠治疗不可复性关节盘前移位的临床研究(1)
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【摘要】 目的 评价颞下颌关节单针推注抽吸灌洗术并关节上腔留注透明质酸钠治疗不可复性关节盘前移位的临床疗效。方法 将56例因不可复性关节盘前移位引起张口受限伴疼痛的患者随机分成两组,实验组行关节上腔灌洗治疗,并同时留注透明质酸钠,对照组只行关节上腔留注透明质酸钠。分析治疗前后患者的疼痛值、张口度变化。结果 治疗后两组患者张口度均较治疗前有显著增加(P<0.01),疼痛亦有显著缓解(P<0.01),同时实验组无论在张口度的改善程度,还是疼痛缓解上都比对照组效果明显。结论 颞下颌关节上腔灌洗术并上腔留注透明质酸钠更能有效改善不可复性关节盘前移位患者的张口度,缓解疼痛,该方法操作简单,有临床推广应用价值。
【关键词】 颞下颌关节; 不可复性关节盘前移位; 关节灌洗术; 透明质酸钠
A clinical study of Arthrocentesis and intraarticular injection of hyaluronate treatment of anterior disc displacement without reduction
ZHENG Fu-yu, ZHENGXiao-tao,WANG Heng-kun,et al.Department of stomatology,Weihai Municipal Hospital, Weihai 264200,China
【Abstract】 Objective To evaluate the clinical efficacy of the TMJ arthrocentesis and intraarticular injection of hyaluronate as a treatment for anterior disc displacement without reduction of the TMJ. Methods 56 patients with limited mouth opening and pain caused by anterior disc displacement without reduction were divided into experimental and control groups.the experimental group were treated by using TMJ arthrocentesis and intraarticular injection of hyaluronate. In the control group, hyaluronate was only injected into the superior cavity.the Clinical data including pain and maximum mouth opening were collected and then analyzed. Results The mouth opening had increased significantly (P<0.001), Jaw pain had also significantly improved (P<0.01). The mouth opening and Jaw pain in experimental group had more improved than the control group. Conclusion Arthrocentesis and intraarticular injection of hyaluronate is more effective in reducing pain and increasing mouth opening in patients with anterior disc displacement without reduction, It is recommended as a simple alternative to more invasive procedures .
【Key words】 Temporomandibular joint;Anterior disc displacement without reduction;Arthrocentesis;Hyaluronate
DOI:10.3760/cma.j.issn 1673-8799.2010.11.20
作者单位:264200威海市立医院
颞下颌关节结构紊乱的主要临床表现是疼痛、弹响或杂音及下颌运动异常,不可复性关节盘前移位临床有典型的关节弹响病史,继之有间断性关节绞锁史;进而弹响消失,张口受限,关节区疼痛。Nitzan等[1]根据关节镜灌洗的原理,在90年代初提出关节上腔灌洗术,并在颞下颌关节紊乱病的治疗中取得满意效果。本研究应用关节上腔灌洗术并上腔留注透明质酸钠治疗不可复性关节盘前移位,与单纯行关节上腔留注透明质酸钠进行对比,通过治疗前后疼痛及张口度的变化程度,观察其临床治疗效果。
1 材料与方法
1.1 一般资料 收集2008年6月至2010年6月我院口腔科门诊因颞下颌关节结构紊乱引起张口受限的患者56例。男性24例,女性32例。年龄25～60岁(平均35岁)。患者无外伤史,无精神因素影响,患侧关节区无明显自发性疼痛,且经药物及其他物理治疗无效 ......
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