锥形束CT评估上颌窦侧壁开窗术术中出血风险

doi:10.13701/j.cnki.kqyxyj.2017.10.020

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (10): 1099-1102.DOI: 10.13701/j.cnki.kqyxyj.2017.10.020

锥形束CT评估上颌窦侧壁开窗术术中出血风险

李濠吉，刘敏^*

西南医科大学附属口腔医院修复科四川泸州 646000

收稿日期:2017-04-21 出版日期:2017-10-20 发布日期:2017-10-24
通讯作者: 刘敏,E-mail:594393820@qq.com
作者简介:李濠吉(1990~ ),男,四川人,住院医师,硕士,主要从事口腔修复与种植的临床治疗工作。

Evaluation of Bleeding Risk in Maxillary Sinus Lateral Wall Fenestration Based on Cone Beam CT

LI Hao-ji, LIU Min

Department of Implantology, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, China.

Received:2017-04-21 Online:2017-10-20 Published:2017-10-24

摘要/Abstract

摘要： 目的:通过锥形束CT观察上颌窦外侧骨壁内血管位置、直径大小,判断引起出血风险大小,以供临床参考。方法:选择2016~2017年至西南医科大学附属口腔医院拍摄CBCT的上后牙缺失患者104例(共208例上颌窦),观察血管至上颌窦底在外侧壁的距离与开窗范围关系,判断开窗时引起出血风险大小。结果:血管至窦底在外侧壁的平均距离(8.26±3.43) mm,血管位于开窗范围内,有损伤风险占26.4%,能引起明显出血占2.2%。结论:在行上颌窦侧壁开窗术中,损伤血管引起明显出血概率较低,窗口上界至上颌窦底在上颌窦外侧壁的距离在7 mm以内属于安全范围,术前通过CBCT能更好的避免损伤血管风险。

关键词: 上颌窦底提升术, 侧壁开窗, 血管, CBCT

Abstract: Objective: To observe the location and diameter of vessel through the lateral wall of maxillary sinus and assess the risk of bleeding during sinus elevation by cone-beam computed tomography. Methods: CBCT images of maxilla in 104 patients(208 maxillary sinus)with maxillary posterior teeth loss from 2016 to 2017 were selected and studied. The distance on lateral wall of maxillary sinus from the lower border of the vessel running through lateral wall to the bottom of the sinus was measured and its relationship to the operating window was estimated the risk of bleeding. Results: The average distance from the blood vessel to the sinus floor was 8.26±3.43mm. 26.4% of blood vessels were located within the area of operating window, posing potential risk of injury, and 2.2% of blood vessels whose diameter were greater than 2mm might cause serious bleeding. Conclusion: The probability of bleeding caused by injury of blood vessel is low in maxillary sinus lateral wall fenestration. The lateral wall distance within 7mm between upper edge of window and the bottom of the maxillary sinus is relatively safe. Preoperative application of CBCT can guide the fenestration and thus reduce the risk of vascular injury.

Key words: Sinus floor elevation, Fenestration, Blood vessels, Cone-beam computed tomography

中图分类号:

R816.98

李濠吉，刘敏. 锥形束CT评估上颌窦侧壁开窗术术中出血风险[J]. 口腔医学研究, 2017, 33(10): 1099-1102.

LI Hao-ji, LIU Min. Evaluation of Bleeding Risk in Maxillary Sinus Lateral Wall Fenestration Based on Cone Beam CT[J]. Journal of Oral Science Research, 2017, 33(10): 1099-1102.

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锥形束CT评估上颌窦侧壁开窗术术中出血风险

Evaluation of Bleeding Risk in Maxillary Sinus Lateral Wall Fenestration Based on Cone Beam CT

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