摘要
目的 探讨唑来膦酸联合手术治疗颌骨骨折的疗效以及对患者口腔功能恢复和骨代谢的影响。方法 选择颌骨骨折患者40例,以随机数字表法分为对照组和研究组,各20例。对照组患者予以手术治疗,研究组患者则在对照组基础上予以唑来膦酸治疗。比较两组患者的临床疗效、口腔功能恢复情况、不良事件发生情况及治疗前后骨代谢[骨源性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、骨钙素(OCN)]水平、生活质量。结果 研究组治疗总有效率为95.00%,显著高于对照组的70.00%(P<0.05)。治疗后,两组BALP、TRACP、β-CTX、OCN水平均低于治疗前,且研究组BALP(88.69±9.07)U/L、TRACP(2.52±0.58)U/L、β-CTX(0.38±0.10)ng/ml、OCN(9.38±1.25)ng/L均显著低于对照组的(105.47±10.51)U/L、(3.04±0.83)U/L、(0.59±0.16)ng/ml、(12.87±1.52)ng/L(P<0.05)。治疗后,研究组患者开口度优于对照组(P<0.05);研究组咬合关系恢复良好率90.00%、颞颌关节功能恢复良好率85.00%均明显高于对照组的60.00%、55.00%(P<0.05)。治疗后,两组生理功能、心理功能、物质生活及社会功能评分均高于治疗前,且研究组生理功能评分(72.82±7.52)分、心理功能评分(69.75±6.82)分、物质生活评分(78.59±7.91)分、社会功能评分(71.04±7.25)分均显著高于对照组的(62.52±6.41)、(60.02±5.91)、(67.82±6.84)、(60.38±6.22)分(P<0.05)。研究组不良事件发生率5.00%低于对照组的30.00%(P<0.05)。结论 对颌骨骨折患者采用唑来膦酸联合手术治疗的疗效可靠,能促进患者口腔功能的恢复,并改善患者骨代谢水平,降低患者不良事件发生率,从而利于患者生活质量的提高,值得推广。
Objective To explore the effect of zoledronic acid combined with surgery on jaw fracture and its influence on oral function recovery and bone metabolism.Methods 40 patients with jaw fracture were selected and divided into a control group and a study group according to random numerical table,with 20 patients in each group.The control group was treated with surgery,and the study group was treated with zoledronic acid on the basis of the control group.Both groups were compared in terms of clinical efficacy,oral function recovery,occurrence of adverse events and bone metabolism[bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase(TRACP),beta C-terminal cross-linked telopeptides of typeⅠcollagen(β-CTX),osteocalcin]and quality of life before and after treatment.Results The total effective rate of the study group was 95.00%,which was significantly higher than the control group's 70.00%(P<0.05).After treatment,BALP,TRACP,β-CTX and OCN levels in both groups were lower than those before treatment;the study group had BALP of(88.69±9.07)U/L,TRACP of(2.52±0.58)U/L,β-CTX of(0.38±0.10)ng/ml and OCN of(9.38±1.25)ng/L,which were significantly lower than(105.47±10.51)U/L,(3.04±0.83)U/L,(0.59±0.16)ng/ml and(12.87±1.52)ng/L in the control group(P<0.05).After treatment,the opening degree of the study group was better than that of the control group(P<0.05).In the study group,the good recovery rate of occlusal relationship and temporomandibular joint function were 90.00%and 85.00%,which were obviously higher than 60.00%and 55.00%in the control group(P<0.05).After treatment,the scores of physical function,psychological function,material life and social function in both groups were higher than those before treatment;in the study group,the physical function score was(72.82±7.52)points,the psychological function score was(69.75±6.82)points,the material life score was(78.59±7.91)points and the social function score was(71.04±7.25)points,which were significantly higher than(62.52±6.41),(60.02±5.91),(67.82±6.84)and(60.38±6.22)points in the control group(P<0.05).The incidence of adverse events in the study group was 5.00%,which was lower than 30.00%in the control group(P<0.05).Conclusion Zoledronic acid combined with surgery for jaw fracture is effective,which can promote the recovery of oral function,improve bone metabolism level and reduce adverse events,thus contributing to the improvement of patients'quality of life,and is worth popularizing.
作者
杨艳艳
YANG Yan-yan(Department of Stomatology,Jinxiang County People's Hospital,Jining 272200,China)
出处
《中国实用医药》
2024年第13期35-38,共4页
China Practical Medicine
关键词
颌骨骨折
唑来膦酸
手术治疗
口腔功能
骨代谢
Jaw fracture
Zoledronic acid
Surgical treatment
Oral function
Bone metabolism
