膜龈手术中腭部结缔组织获取方式与术后疼痛的相关性分析

doi:10.13591/j.cnki.kqyx.2025.06.008

摘要/Abstract

摘要：

目的评估在膜龈手术中去上皮游离龈组织技术和单切口技术获取腭部结缔组织对患者腭部供区术后疼痛的影响。方法 30例患者,对照组为去上皮游离龈组织技术组,试验组为单切口技术组。记录受区牙位角化龈宽度、垂直切口数目、牙位数、供区黏膜厚度、移植物宽度、移植物长度、移植物厚度、手术时长、麻醉药用量,记录术后生活质量评分量表,视觉模拟量表。采用SPSS 26.0软件对数据进行相关性分析。结果实验组比对照组术后生活质量评分显著更低,两组供区VAS总分无显著差异。对于膜龈手术术后总疼痛水平而言,垂直切口数量和移植物厚度与术后疼痛水平成正相关。腭黏膜厚度与术后疼痛水平成负相关。结论在膜龈手术中,患者腭部供区术后疼痛程度与选择去上皮游离龈组织技术还是单切口技术获取上皮下结缔组织无关。术者在选择术式时还应该结合患者供区解剖因素、手术技术水平及经验、美学要求等综合考量。

关键词: 膜龈手术, 术后疼痛, 结缔组织, 视觉模拟量表

Abstract:

Objective To evaluate the impact of different methods of harvesting palatal connective tissue on patients’ postoperative pain at the palatal donor site. Methods A total of 30 patients were included. The control group was de-epithelialized free gingival graft technique group, and the experimental group was the single-incision technique group. The keratinized gingival width of the recipient site, number of vertical incisions, number of teeth, donor site mucosa thickness, graft width, graft length, graft thickness, operation time and amount of anesthetic were recorded. The postoperative quality of life rating scale and visual analog scale were completed and statistical analysiswas performedon the results by SPSS 26.0. Results The postoperative quality of life score of the experimental group was significantly lower than that of the control group, and there was no significant difference in the total VAS score of the donor site. In terms of the total postoperative pain level after mucogingival surgery,the number of vertical incisions and graft thickness were positively correlated with the pain. Palate mucosal thickness was negatively correlated with postoperative pain levels. Conclusion In mucogingival surgery, the degree of postoperative pain in the donor palatal region of the patient is independent of the choice of de-epithelialized free gingival graft technique or single-incision technique to obtain subepithelial connective tissue. The surgeon should also give comprehensive considerationsto the anatomical factors of the patient’s donor site, surgical technical level and experience, and aesthetic requirements when selecting the surgical method.

Key words: mucogingival surgery, postoperative pain, connective tissue, visual analogue scale

中图分类号:

R782.05

胡晗, 董家辰, 廖悦, 张桓瑜, 宋忠臣. 膜龈手术中腭部结缔组织获取方式与术后疼痛的相关性分析[J]. 口腔医学, 2025, 45(6): 440-444.

HU Han, DONG Jiachen, LIAO Yue, ZHANG Huanyu, SONG Zhongchen. Correlation analysis between palatal connective tissue acquisition methods and postoperative pain after mucogingival surgery[J]. Stomatology, 2025, 45(6): 440-444.

图/表 4

表1

两组患者的一般资料"

基本特征	对照组	实验组	χ²/t	P
性别(男/女)	5/10	6/9	0.144^a	0.705
年龄/(岁, $x ¯$ ±s)	34.00±4.71	30.80±5.33	1.742^b	0.439
婚姻状况(已婚/未婚)	8/7	6/9	0.536^a	0.464
教育程度(高中及以下/本科及以上)	2/13	0/15	2.143^a	0.143
稳定工作(有/无)	13/2	13/2	0.000^a	1.000
吸烟习惯(有/无)	0/15	0/15	0.000^a	1.000
饮酒习惯(有/无)	0/15	0/15	0.000^a	1.000
膜龈手术经历(有/无)	2/13	0/15	2.143^a	0.143
对手术了解程度(了解/不了解)	0/15	0/15	0.000^a	1.000

表1

表2

图1

表3

参考文献 19

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测量项目	对照组	实验组	P
角化龈宽度/mm	1.0(1.0,2.0)	1.0(1.0,1.5)	0.461
腭黏膜厚度/mm	4.0(4.0,4.0)	3.0(3.0,3.0)	0.061
垂直切口数量	0.0(0.0,2.0)	0.0(0.0,2.0)	0.389
受区牙数	2.0(1.0,3.0)	2.0(2.0,3.0)	0.116
受区麻药用量/mL	1.7(1.7,1.7)	1.7(1.7,2.0)	0.683
移植物厚度/mm	2.0(2.0,2.0)	1.0(1.0,1.5)	0.008^*
移植物宽度/mm	6.0(6.0,7.0)	5.0(5.0,6.0)	0.345
移植物长度/mm	12.0(12.0,12.0)	12.0(12.0,13.0)	0.137
移植物获取时间/min	10.0(10.0,13.0)	6.0(5.0,10.0)	0.009^*
供区麻药用量/mL	1.7(1.7,1.7)	1.7(1.7,2.0)	0.098
术后生活质量总分	6.00±2.13	5.87±4.45	0.013^*
供区VAS总分	13.93±7.23	15.40±7.85	0.127

模型	B	标准误	β	t	P	容差	VIF
常量	57.536	38.240		1.505	0.150
年龄	0.090	0.361	0.016	0.250	0.805	0.670	1.493
角化龈宽度	3.948	2.609	0.094	1.513	0.148	0.691	1.447
腭黏膜厚度	-20.443	3.283	-0.562	-6.227	0.000^*	0.331	3.021
垂直切口数量	11.900	2.954	0.329	4.028	0.001^*	0.403	2.480
受区牙数	1.211	1.413	0.059	0.857	0.403	0.577	1.734
受区麻药用量	6.479	5.584	0.095	1.160	0.261	0.405	2.471
移植物厚度	11.957	5.145	0.184	2.324	0.032^*	0.428	2.335
移植物宽度	-1.047	3.069	-0.028	-0.341	0.737	0.387	2.586
移植物长度	-1.137	0.444	-0.270	-2.562	0.020^*	0.242	4.134
移植物获取时间	-0.418	0.538	-0.054	-0.777	0.448	0.554	1.807
供区麻药用量	8.977	4.238	0.192	2.118	0.048^*	0.329	3.044