单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究

doi:10.13701/j.cnki.kqyxyj.2020.04.009

口腔医学研究 ›› 2020, Vol. 36 ›› Issue (4): 341-345.DOI: 10.13701/j.cnki.kqyxyj.2020.04.009

单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究

张立刚, 易杰, 姚礼, 黄桂林^*, 胡小华, 张霓霓, 代敏

遵义医科大学口腔医学院·附属口腔医院口腔颌面外科

收稿日期:2019-08-13 出版日期:2020-05-28 发布日期:2020-05-28
通讯作者: 黄桂林,E-mail:chaojiehuanghgl@163.com
作者简介:张立刚(1987~ ),男,山东枣庄人,硕士,讲师,主治医师,主要从事口腔颌面肿瘤外科临床研究工作。
基金资助:
国家自然科学基金(编号:81760201); 科技部国家“十三五”重点研发计划项目子课题(编号:2016YFC1102804); 贵州省科技厅科研项目(编号:黔科合基[2016]1170); 遵义医学院硕士启动基金(2016年度编号:KY2016-3#); 遵义医学院附属口腔医院院基金(编号:KY2015-12); 遵义市科学技术局、遵义医学院附属口腔医院联合科技研发资金项目(编号:遵市科合社字[2018]248); 住院医师规范化培养院内教改基金项目(编号:2018-06)

Clinical Study of Decompression Combined with Curettage for Unicystic Ameloblastoma

ZHANG Ligang, YI Jie, YAO Li, HUANG Guilin^*, HU Xiaohua, ZHANG Nini, DAI Min

Department of Oral Maxillofacial Surgery, Hospital and School of Stomatological, Zunyi Medical University, Zunyi 563099, China

Received:2019-08-13 Online:2020-05-28 Published:2020-05-28

摘要/Abstract

摘要： 目的: 探讨开窗减压术联合刮治术治疗单囊型成釉细胞瘤的治疗效果和预后。方法: 20例单囊型成釉细胞瘤行开窗减压术,术后佩戴超软热凝树脂塞治器,Ⅱ期行刮治术,术后严密随访,观察瘤腔变化。结果: 锥形束CT显示病变范围明显缩小,病变区解剖结构接近正常。开窗术后3个月瘤腔平均缩小28.66%,术后6个月平均缩小58.51%,术后12个月平均缩小为79.33%,瘤腔面积与术前比较明显缩小(P＜0.05)。术后6个月瘤腔骨密度冠状位、矢状位及水平位分别为371.32、361.74、384.71 Hu,术后12个月分别为517.64、523.22、521.05 Hu,与术前相比有明显差异(P＜0.05)。术后12~24个月行二期刮治,随访3~5年无复发。结论: 单囊型成釉细胞瘤行开窗减压术,术后佩戴超软热凝树脂塞治器能维持开窗口通畅,在瘤腔变化不明显时进行二期刮治术,是治疗单囊型成釉细胞瘤的一种有效方法。

关键词: 单囊型成釉细胞瘤, 塞治器, 开窗减压术, 刮治术

Abstract: Objective: To investigate the efficacy and prognosis of decompression combined with curettage for unicystic ameloblastoma. Methods: 20 cases of unicystic ameloblastoma were treated with decompression. The cyst plug with soft liner thermosetting resin was used to keep the wound open and a second stage curettage was performed. The changes of tumor cavity were observed after the operation. Results: Patient imaging showed that the lesion range was significantly reduced, and the anatomy of the lesion area was close to normal. The tumor cavity decreased by 28.66% on average 3 months after operation, and decreased by 58.51% on average 6 months, decreased by 79.33% on average 12 months. After the surgery, the sizes of the tumor cavity shrank, all these had statistical significance (P＜0.05). Then 6 months later, the bone mineral densities at coronal and sagittal and horizontal respectively were 371.32 Hu, 361.74 Hu, and 384.71 Hu. Followed-up 12 months, the bone mineral densities increased to 517.64 Hu, 523.22 Hu, and 521.05 Hu (P＜0.05). The second stage curettage was performed 12 to 24 months after operation. No recurrence of tumor was observed in the 3 to 5 years of follow up. Conclusion: It is an effective method for the treatment of unicystic ameloblastoma by decompression combined with curettage. And the cyst plug with soft liner thermosetting resin was used to keep the wound open. Second stage curettage was performed when the changes of tumor cavity were not obvious.

Key words: unicystic ameloblastoma, obturator, decompression, curettage

张立刚, 易杰, 姚礼, 黄桂林, 胡小华, 张霓霓, 代敏. 单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究[J]. 口腔医学研究, 2020, 36(4): 341-345.

ZHANG Ligang, YI Jie, YAO Li, HUANG Guilin, HU Xiaohua, ZHANG Nini, DAI Min. Clinical Study of Decompression Combined with Curettage for Unicystic Ameloblastoma[J]. Journal of Oral Science Research, 2020, 36(4): 341-345.

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单囊型成釉细胞瘤行开窗减压术联合刮治术的临床研究

Clinical Study of Decompression Combined with Curettage for Unicystic Ameloblastoma

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