【摘要】 目的:分析不同病程的单侧不可复性关节盘前移位（ADDWOR）患者的临床表现及关节盘影像学特征。方法:纳入92例患者，根据病程分为3组：A组31例（病程≤3个月）,B组31例（3个月<病程≤6个月）,C组30例（病程>6个月）,收集并比较3组患者的年龄、性别、患侧、最大张口度（MMO）、疼痛状态视觉模拟评分（VAS）、关节盘的长度、厚度、关节盘前移角度、关节盘前移位距离，关节盘形态的差异。结果:3组患者的年龄、性别占比、患侧分布无明显统计学差异（P>0.05）。MMO中C组>B组>A组；VAS疼痛评分，A组>B组>C组；关节盘前移角度，C组>B组>A组；以上指标，任意两组之间差异均具有统计学意义（P<0.05）。关节盘长度依次递减，但A组与B组间无显著统计学差异(P_A-B=0.098);C组与A、B组相比，差异均具有统计学意义（P<0.001）。关节盘厚度中，B组>C组>A组，A组与B组间有统计学差异(P_A-B=0.013);C组与A、B组相比，差异均无统计学意义（P>0.05）。关节盘前移距离相比，3组间差异无统计学意义（P=0.291）。3组患者的关节盘形态存在差异（P=0.005）,其中A组以双凹型为主，B组以半凹形为主，C组以折叠扭转形为主。结论:随着ADDWOR病程增加，患者疼痛及张口受限趋向于减轻，但关节盘前移程度逐渐增加，病程3个月以内的患者其关节盘长度及形态维持较好，病程6个月以上时关节盘的长度显著缩短以及形态明显折叠变形。更多还原

【Abstract】 Objective:This study aimed to analyze the clinical manifestations and disc imaging characteristics of patients with unilateral anterior disc displacement without reduction（ADDWOR）at different stages.Methods:A total of 92 patients with unilateral ADDWOR were enrolled and divided into three groups based on disease duration: Group A（31 cases with disease duration≤3 months）,Group B（31 cases with disease duration between 3 and 6 months）,and Group C（30 cases with disease duration>6 months）.The age, gender, affected side, maximal mouth opening（MMO）,visual analog scale（VAS）pain score, articular disc length, thickness, anterior displacement angle, displacement distance, and disc shape were collected and compared among the three groups.Results:No statistically significant differences were observed among the three groups regarding age, gender distribution, or affected side（all P>0.05）.In terms of MMO,Group C>Group B>Group A,for VAS pain score, Group A>Group B>Group C,regarding the angle of anterior displacement of the disc, Group C>Group B>Group A.There were statistically significant differences between any two groups in the above indicators（all P<0.05）.The length of the articular disc decreased in turn, but there was no significant difference between Group A and B(P_A-B=0.098),compared with Group A and B,Group C showed statistically significant differences（all P<0.001）.In terms of articular disc thickness, Group B>Group C>Group A,and there was a statistically significant difference between Group A and B(P_A-B=0.013),compared with Group A and B,Group C showed no statistically significant differences（all P>0.05）.There were no statistically significant differences in the anterior displacement distance of the articular disc（P=0.291）.The articular disc shapes differed among the three groups of patients（P=0.005）,with a biconcave shape predominantly in Group A,a hemiconcave shape mainly in Group B,and a folded shape mostly in Group C.Conclusion:With the progression of ADDWOR,patients’ pain and limited mouth opening tend to decrease, while the degree of articular disc anterior displacement gradually increases.Patients with a disease course within 3 months maintain relatively better disc length and morphology.However, When the disease duration exceeds 6 months, the articular disc length significantly shortens, and its morphology shows marked folding and deformation.更多还原