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目的:评价异种脱细胞真皮基质修复膜在口腔黏膜下纤维性变手术治疗中的应用效果。方法:8例重度口腔黏膜下纤维性变患者,经鼻腔气管插管全麻下切除双侧颊部翼下颌韧带前方区域纵行的纤维条索,术中被动开口度达正常范围后,剪取相应大小的异种脱细胞真皮基质修复膜覆盖黏膜缺损创面,间断缝合后,碘纺纱包加压固定。术后10～14d拆除纱包与缝线后开始开口训练,定期随访并进行类固醇皮质激素黏膜下局部注射等辅助治疗,通过伤口愈合、瘢痕软化及开口度改善等指标评价手术效果。采用SPSS16.0软件包对数据进行单因素方差分析。结果:8例患者双侧颊部纤维条索切除后形成的手术创面,采用异种脱细胞真皮基质修复膜进行修复均获得成功,无感染或排异等并发症发生。术后随访6～18个月,患者颊部原手术区黏膜红润,质地柔软,开口困难明显改善。术前开口度为(12.04±2.93)mm,术中开口度为(35.46±3.17)mm,术后6个月时的开口度为(29.33±4.28)mm,经统计学分析,差异具有显著性(P<0.05)。结论:应用异种脱细胞真皮基质修复膜修复重度口腔黏膜下纤维性变手术治疗中的黏膜缺损创面,能够起到促进创面早期愈合、减轻瘢痕形成与改善开口困难的作用,其操作简单易行,值得临床推广应用。
Objective: To evaluate the effect of xenogenic acellular dermal matrix in the surgical treatment of oral submucous fibrosis. Methods: Eight patients with severe oral submucous fibrosis underwent nasal endotracheal intubation under general anesthesia to remove bilateral cheeks in the anterior mandibular ligament longitudinally fibrous cords, the passive opening in the surgery within the normal range, the cut The corresponding size of acellular acellular dermal matrix repair membrane covering mucosal defect wound, intermittent suture, iodine spinning package pressure fixation. Ten to 14 days after the operation, sutures were removed and sutures were opened. Regular follow-up and corticosteroid submucosal injection were used to treat the wounds. The effects of wound healing, scar softening and improvement of opening degree were evaluated. Data were analyzed by one-way ANOVA using SPSS16.0 software package. Results: The surgical wounds formed in eight patients with bilateral cheek fibroids were successfully repaired by using acellular dermal matrix repair membrane. No complications such as infection or rejection occurred. Postoperative follow-up of 6 to 18 months, the original cheek surgery in patients with mucosal rosy, soft texture, opening difficulties were significantly improved. The preoperative opening degree was (12.04 ± 2.93) mm, the opening degree was (35.46 ± 3.17) mm, the opening degree at 6 months after operation was (29.33 ± 4.28) mm, and the difference was statistically significant (P <0.05). Conclusion: The application of xenogenic acellular dermal matrix in the repair of mucosal defects in severe oral submucous fibrosis can promote early wound healing, alleviate scar formation and improve the openness of the wound. The operation is simple and easy, Worthy of clinical application.