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下颌骨骨折感染会导致慢性疼痛综合征的发生吗?基于功能指标、标准化问卷和生活质量评估对患者治疗结果进行评估。

Does infection of a mandibular fracture lead to the development of chronic pain syndrome? Assessment of patient treatment results based on functional indicators, standardized questionnaires and quality of life assessment.

作者信息

Valieva Lejli U, Pankratov Alexander S, Mikiya Archil O

机构信息

Department of Maxillofacial Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia.

Department of General and Surgical Dentistry, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia.

出版信息

J Oral Facial Pain Headache. 2025 Mar;39(1):176-186. doi: 10.22514/jofph.2025.018. Epub 2025 Mar 12.

Abstract

BACKGROUND

Fractures of the mandible are among the most common injuries to the bones of the facial skeleton and are associated with a relatively high incidence of complications, particularly purulent-inflammatory conditions, especially when treatment is delayed. These complications and surgical interventions can damage the masticatory muscles, disrupt their physiological balance, impair mandibular movement and contribute to pain syndrome development. This study aimed to investigate the dynamics of pain severity, the restoration of stomatognathic apparatus function following purulent-inflammatory complications of mandibular fractures and their impact on patients' quality of life.

METHODS

We assessed the data of 15 patients with mandibular fractures without fragment displacement but complicated by purulent-inflammatory processes. Surgical intervention was combined with intermaxillary immobilization for four weeks, followed by myogymnastic exercises during rehabilitation. Mandibular movement amplitude was measured in three planes and surveys were conducted. Pain syndrome was assessed using the Visual Analog Scale and McGill Pain Questionnaire, and their psycho-emotional status was evaluated using the Spielberger-Hanin Anxiety Scale and Beck Depression Inventory. Quality of life was measured using the Medical Outcomes Study-Short Form questionnaire (SF-36). Assessments were performed on the fourth postoperative day, immediately after splint removal,and at one, six and twelve months post-operation. Mandibular mobility was also measured seven and fourteen days post-splint removal.

RESULTS

The results were then compared with a group of healthy volunteers. Over one year of observation, we found that all functional and psychometric parameters of the patients remained significantly lower than those of the healthy volunteer group, and these deficits predisposed patients to muscle dysfunction and negatively impacted their quality of life.

CONCLUSIONS

Therefore, continued research is essential to develop effective treatment and rehabilitation strategies for this patient population.

摘要

背景

下颌骨骨折是面部骨骼中最常见的损伤之一,并发症发生率相对较高,尤其是化脓性炎症,特别是在治疗延迟时。这些并发症和手术干预可能会损伤咀嚼肌,破坏其生理平衡,损害下颌运动,并导致疼痛综合征的发展。本研究旨在调查下颌骨骨折化脓性炎症并发症后疼痛严重程度的动态变化、口颌系统功能的恢复情况及其对患者生活质量的影响。

方法

我们评估了15例下颌骨骨折无骨折块移位但并发化脓性炎症的患者的数据。手术干预联合颌间固定四周,随后在康复期间进行肌体操锻炼。测量下颌在三个平面上的运动幅度并进行调查。使用视觉模拟量表和麦吉尔疼痛问卷评估疼痛综合征,并使用斯皮尔伯格 - 哈宁焦虑量表和贝克抑郁量表评估他们的心理情绪状态。使用医学结局研究简表问卷(SF - 36)测量生活质量。在术后第四天、夹板拆除后立即以及术后1个月、6个月和12个月进行评估。在夹板拆除后7天和14天也测量下颌活动度。

结果

然后将结果与一组健康志愿者进行比较。经过一年的观察,我们发现患者的所有功能和心理测量参数仍显著低于健康志愿者组,这些缺陷使患者易患肌肉功能障碍并对其生活质量产生负面影响。

结论

因此,持续的研究对于为该患者群体制定有效的治疗和康复策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e71/11933926/8c3ada1343eb/fig1.jpg

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