摘要：

目的： 探讨开窗减压术联合二期刮治术治疗巨大型颌骨囊肿的临床疗效，并分析该方法对患者围手术期指标及复发情况的影响。方法： 采用回顾性研究设计，收集2021年5月—2023年9月期间本院收治的80例巨大型颌骨囊肿患者的临床资料。根据手术方式将患者分为2组，接受传统囊肿刮除术治疗的38例患者纳入传统刮治组，接受开窗减压术联合二期刮治术的42例患者纳入研究组。比较2组患者治疗有效率、术后炎症指标、并发症发生率、骨质恢复情况（骨质增生厚度、骨密度、囊腔缩小百分比）及囊肿复发率，并采用健康调查简表36（36-Item Short Form Health Survey，SF-36）评估2组患者生活质量。结果： 研究组的治疗有效率（92.86%）高于传统刮治组（76.32%）（P<0.05）；术后3 d，研究组的白细胞介素-6（interleukin-6，IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、C反应蛋白（C-reactive protein，CRP）水平均低于传统刮治组（P<0.05）；研究组的术后并发症发生率（4.76%）显著低于传统刮治组（21.05%）（P<0.05）；术后6个月，研究组骨质增生厚度、骨密度和囊腔缩小百分比均显著高于传统刮治组（P<0.001）；研究组SF-36量表各维度评分均显著高于传统刮治组（P<0.05）；研究组复发率（2.38%）显著低于传统刮治组（18.42%）（P<0.01）。结论： 开窗减压术联合二期刮治术治疗巨大型颌骨囊肿疗效确切，可有效减轻术后炎症反应，促进骨质修复，改善患者生活质量，并显著降低并发症发生率及复发率。

关键词: 开窗减压, 二期刮治术, 巨大型颌骨囊肿, 围手术期指标, 复发

Abstract:

Objective: To investigate the clinical efficacy of decompression combined with secondary curettage for the treatment of large jaw cysts, and analyze the impact of this technique on patients' perioperative outcomes and recurrence rates. Methods: A retrospective study was conducted, collecting clinical data from 80 patients with large jaw cysts admitted to our hospital between May 2021 and September 2023. Based on the surgical approach, patients were divided into two groups: 38 patients treated with conventional curettage were assigned to the conventional curettage group, while 42 patients treated with decompression combined with secondary curettage were assigned to the study group. The two groups were compared regarding treatment effectiveness, postoperative inflammatory markers, complication rates, bone recovery status (bone formation thickness, bone density, reduction rate of the cystic cavity), and cyst recurrence rate. Quality of life was assessed using the 36-Item Short Form Health Survey (SF-36). Results: The treatment effectiveness rate in the study group (92.86%) was higher than that in the conventional curettage group (76.32%) (P<0.05). On postoperative day 3, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in the study group were all lower than those in the conventional curettage group (P<0.05). The postoperative complication rate in the study group (4.76%) was significantly lower than that in the conventional curettage group (21.05%) (P<0.05). At 6 months postoperatively, the bone formation thickness, bone density, and reduction rate of the cystic cavity in the study group were significantly higher than those in the conventional curettage group (P<0.001). All domain scores of the SF-36 in the study group were significantly higher than those in the conventional curettage group (P<0.05). Furthermore, the recurrence rate in the study group (2.38%) was significantly lower than that in the conventional curettage group (18.42%) (P<0.01). Conclusion: Decompression combined with secondary curettage is an effective treatment for large jaw cysts. It can effectively reduce postoperative inflammatory response, promote bone repair, improve patients' quality of life, and significantly lower the incidence of complications and recurrence.

Key words: fenestration and decompression, secondary curettage, large jaw cyst, perioperative indicator, recurrence