矿化胶原联合浓缩生长因子治疗颌骨囊肿术后骨缺损的临床研究

doi:10.12439/kqhm.1005-4979.2023.05.007

摘要/Abstract

摘要：

目的：探究新型矿化胶原（mineralized collagen，MC）骨充填材料联合浓缩生长因子（concentrated growth factor，CGF）治疗颌骨囊肿刮治术后骨缺损的临床疗效。方法：对120例颌骨囊肿患者进行回顾性分析，采用随机数字法分为CGF组（A组，40例）、MC组（B组，40例）及MC+CGF组（C组，40例），比较3组术后3、6、12个月时的成骨效果、疼痛及肿胀程度。结果：A组骨缺损区在术后3、6、12个月时，CT值分别为（220.07±29.25）、（358.77±48.42）、（473.07±55.63）HU，B组分别为（281.00±36.14)、（464.66±51.30)、（569.10±71.21) HU，C组分别为（344.14±39.31）、（528.79±63.98）、（603.62±95.04）HU，两两比较差异有统计学意义（P<0.05）；在术后2 d时，3组患者疼痛程度视觉模拟评分法（visual analogue scale，VAS）评分依次为64.13±11.46、65.31±9.89、51.68±14.24，C组与A、B两组相比，差异均有统计学意义（P<0.05）；通过粗线测量法测得C组的术后肿胀程度较A、B 两组轻，差异有统计学意义（P<0.05）。结论：MC联合CGF应用于颌骨囊肿刮治患者的方法可降低患者术后疼痛、肿胀程度，且能有效促进局部成骨，具有良好疗效。

关键词: 矿化胶原, 浓缩生长因子, 颌骨囊肿, 骨缺损

Abstract:

Objective: To evaluate the clinical effects of a new mineralized collagen (MC) bone filling material combined with concentrated growth factor (CGF) in repairing bone defects of jaw cysts. Methods: The sample population consisted of 120 patients after jaw cysts surgery. They were divided into CGF group (group A, 40 patients), MC group (group B, 40 patients) and MC+CGF group (group C, 40 patients) respectively using the random number method. The osteogenic results, pain and swelling degree at 3, 6 and 12 months after surgery were collected and compared. Results: The CT values of the bone defect area in group A were (220.07±29.25), (358.77±48.42), (473.07±55.63) HU at 3, 6, and 12 months postoperatively, and (281.00±36.14), (464.66±51.30), (569.10±71.21) HU in group B; and (344.14±39.31), (528.79±63.98), (603.62±95.04) HU in group C, respectively. Statistical differences between each two groups were found (P<0.05). The visual analogue scale (VAS) scores of pain level in these groups at 2 d postoperatively were 64.13±11.46, 65.31±9.89 and 51.68±14.24, with statistical significance (P<0.05) between them. The degree of postoperative swelling was less in group C than those in groups A and B measured by crude line measurement, and the differences were statistically significant (P<0.05). Conclusion: The current retrospective analysis indicates that applicaton of MC combined with CGF can reduce the degree of postoperative pain, swelling and effectively promote bone regeneration in bone cavity of jaw cysts.

Key words: mineralized collagen, concentrated growth factor, jaw cyst, bone defect

中图分类号:

R782

孙昊, 林超, 马旭彤, 仲若恺, 范欣. 矿化胶原联合浓缩生长因子治疗颌骨囊肿术后骨缺损的临床研究[J]. 《口腔颌面外科杂志》, 2023, 33(5): 320-325.

SUN Hao, LIN Chao, MA Xutong, ZHONG Ruokai, FAN Xin. Mineralized collagen combined with concentrated growth factor to stimulate bone regeneration in cyst of the jaw: A retrospective study[J]. 《Journal of Oral and Maxillofacial Surgery》, 2023, 33(5): 320-325.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2023/V33/I5/320

图/表 5

图1 制备MC+CGF及制备CGF生物膜 A.制备CGF；B.CGF与MC按1∶1混合；C.CGF与MC的混合物；D.纱布法制备CGF膜。

Figure 1 Preparation of CGF mixing with MC, and preparation of CGF biofilm

表1 3组患者手术日及术后2、5 d时VAS评分的比较

Table 1 Comparison of the VAS scores of three groups at the time of surgery and 2, 5 d after surgery

组别	VAS评分
组别	手术日	术后2 d	术后5 d
A组	40.83±14.11	64.13±11.46	23.98±9.55
B组	38.87±13.05	65.31±9.89 ^①	21.36±7.54
C组	37.85±13.11	51.68±14.24 ^①，②	20.30±7.73

表2 3组患者术后2 d时术区肿胀程度的比较[n(%)]

Table 2 Comparison of the degree of swelling in the operative area between three groups 2 d after surgery [n(%)]

组别	术区肿胀程度
组别	无肿胀	轻度肿胀	中度肿胀	重度肿胀
A组	3(7.5)	9(22.5)	7(17.5)	21(52.5)
B组	2(5.0)	9(22.5)	10(25.0)	19(47.5)
C组	8(20.0)^①，②	16(40.0)^①，②	9(22.5)^①，②	7(17.5)^①，②

图2 3组各时间点骨缺损区CT值的比较 *表示P<0.05，与A组比较；#表示P<0.05，与C组相比。

Figure 2 Comparison of CT values in the bone defect area at each time point between three groups

图3 3组病损区术前，术后3、6、12个月时的CBCT图像 A—D. 分别为A组术前，术后3、6、12个月时的影像；E—H. 分别为B组术前，术后3、6、12个月时的影像；I—L. 分别为C组术前，术后3、6、12个月时的影像。

Figure 3 CBCT images showing bone lesions before operation, 3, 6 and 12 months after operation between three groups

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