下颌骨重建术后患者咀嚼功能评估工具及影响因素的研究进展

doi:10.3969/j.issn.1674-8115.2025.04.015

上海交通大学学报（医学版） ›› 2025, Vol. 45 ›› Issue (4): 517-522.doi: 10.3969/j.issn.1674-8115.2025.04.015

下颌骨重建术后患者咀嚼功能评估工具及影响因素的研究进展

张悦¹, 顾芬²(), 王悦平³, 杨文玉³, 赵小妹³

^1.上海交通大学护理学院，上海 200025
^2.复旦大学附属华东医院护理部，上海 200040
^3.上海交通大学医学院附属第九人民医院护理部，上海 200011

收稿日期:2024-05-29 接受日期:2024-10-28 出版日期:2025-04-28 发布日期:2025-04-28
通讯作者: 顾芬 E-mail:gufen927@163.com
作者简介:张悦（1998—），女，硕士生；电子信箱：zhangyue11300023@163.com。
基金资助:
上海申康医院发展中心项目(SHDC2022CRS011B)

Research progress on masticatory function assessment tools and influencing factors in patients after mandibular reconstruction

ZHANG Yue¹, GU Fen²(), WANG Yueping³, YANG Wenyu³, ZHAO Xiaomei³

^1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
^2.Nursing Department, Huadong Hospital, Fudan University, Shanghai 200040, China
^3.Nursing Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2024-05-29 Accepted:2024-10-28 Online:2025-04-28 Published:2025-04-28
Contact: GU Fen E-mail:gufen927@163.com
Supported by:
Shanghai Hospital Development Center Foundation(SHDC2022CRS011B)

摘要/Abstract

摘要：

下颌骨重建是指通过移植自体骨等技术恢复下颌骨的连续性，从而恢复患者的基本容貌，重建咬合关系，恢复张口、咀嚼、吞咽等功能，达到口腔颌面形态和功能的统一。由于咀嚼需要咀嚼肌、下颌、牙列及舌的共同配合，因此咀嚼功能的恢复，不仅可以作为判断手术成功的有利依据，且能够提升患者生活质量，使其尽早回归正常生活。目前，针对下颌骨重建术后患者的口腔功能康复，临床上已在吞咽、咬合及言语评估领域建立了标准化工具并开展针对性训练，取得了显著疗效。然而，咀嚼功能相关研究仍面临两大挑战：其一，现有评估工具多侧重单一维度，如咀嚼效率或主观感受，尚未建立整合咬合力分布、口腔感知觉等多维度的评估体系；其二，虽已有个别研究探讨影响术后咀嚼功能的因素，但尚未形成系统性共识，导致临床干预缺乏精准性和个性化，显著延长了患者的康复周期。该文综述现有下颌骨重建术后患者咀嚼功能评估工具的适用范围及局限性，并系统解析影响术后咀嚼功能的关键因素，旨在推动临床从“结构重建”向“功能-感知协同康复”的理念转变，为构建循证导向的个性化咀嚼康复方案提供理论框架。

关键词: 下颌骨重建术, 咀嚼功能, 康复护理

Abstract:

Mandibular reconstruction refers to the restoration of the continuity of the mandible through techniques such as autologous bone grafting, thereby restoring the patient's basic appearance, reconstructing the occlusal relationship, and restoring functions such as opening the mouth, chewing, and swallowing, in order to achieve a unity of oral and maxillofacial forms and functions. Due to the fact that mastication necessitates the coordinated efforts of the masticatory muscles, mandible, dental arch, and tongue, the recovery of masticatory function not only serves as a robust indicator for the success of surgery but also enhances the patients' quality of life, facilitating an early return to normal life. Currently, for the rehabilitation of oral function in patients after mandibular reconstruction surgery, standardized tools have been established in the fields of swallowing, occlusion, and speech assessment, and targeted training has been implemented, yielding significant therapeutic outcomes. However, research related to masticatory function faces two major challenges. First, existing assessment tools primarily focus on a single dimension, such as masticatory efficiency or subjective perception, and an integrated assessment system that encompasses multiple dimensions, including bite force distribution and oral sensory perception, has not yet been established. Second, although individual studies have explored factors affecting postoperative masticatory function, a systematic consensus has not been veached, leading to a lack of precision and individualization in clinical interventions, which significantly prolongs the patients' rehabilitation period. This paper reviews the scope and limitations of existing assessment tools for masticatory function in patients after mandibular reconstruction and systematically analyzes the key factors affecting postoperative masticatory function, aiming to promote a shift in clinical practice from "structural reconstruction" to a "function-perception collaborative rehabilitation" approach, and to provide a theoretical framework for constructing evidence-based, personalized masticatory rehabilitation programs.

Key words: mandibular reconstruction, masticatory function, rehabilitation nursing

中图分类号:

R782.2

张悦, 顾芬, 王悦平, 杨文玉, 赵小妹. 下颌骨重建术后患者咀嚼功能评估工具及影响因素的研究进展[J]. 上海交通大学学报（医学版）, 2025, 45(4): 517-522.

ZHANG Yue, GU Fen, WANG Yueping, YANG Wenyu, ZHAO Xiaomei. Research progress on masticatory function assessment tools and influencing factors in patients after mandibular reconstruction[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(4): 517-522.

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下颌骨重建术后患者咀嚼功能评估工具及影响因素的研究进展

Research progress on masticatory function assessment tools and influencing factors in patients after mandibular reconstruction

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