摘要
目的:总结颌骨放射性骨坏死的诊治特点,探索其预防方法。方法:对1995—2006年间收治的19例颌骨放射性骨坏死病例进行回顾性分析及随访。结果:19例中12例是鼻咽癌放疗后引起的,发生于下颌骨者远多于上颌骨。平均放疗剂量68.1Gy,均为外照射;发生在放射后1～5年间者占80.4%。临床上主要表现为疼痛、感染、组织坏死脱落和张口受限等。在治疗上主要采用以扩大清除坏死组织为主的手术治疗,高压氧作为辅助治疗。结论:放射损害是颌骨放射性骨坏死发生的根本原因,损伤和感染是诱发因素;局部死骨的扩大切除是根治的主要方法;加强口腔护理、避免放疗区的损伤和感染是预防的关键。
Objective： To summarize the diagnosis , therapy and preventive measures of osteoradionecrosis of the jaws （ORNJ）. Methods： 19 cases of ORNJ between 1995 and 2006 were retrospectively reviewed. Results： 12 cases were initiated after radiotherapy of nasopharyngeal carcinomas; the lower jaw was far more prevalent than the upper jaw. Average irradiation dose was 68.1 Gy, and all were external irradiation; 80.4% of the cases manifested between 1 to 5 years after radiotherapy.Clinical symtoms included pain, infection, tissue necrosis and limitation of mouth opening, etc. Except early cases treated by conservation, sequestrectomy should be performed. Hyperbaric oxygen may be an adjuvant therapy. Conclusion： To ORNJ, radiation damage is a fundamental cause, local injury and infection are inducing factors, mandiblerelated factors may include structure and regional anatomy. Enlarged removal of sequestlum is the main treatment. To improve the level of radiotherapy, enhance nursing of mouth and avoid injury and infection of the region are effective preventive measures.
出处
《口腔颌面外科杂志》
CAS
2009年第2期117-120,共4页
Journal of Oral and Maxillofacial Surgery
关键词
放射性骨坏死
颌骨
治疗
预防
osteoradionecrosis
jaw
therapy
prevention
