颌骨放射性骨坏死的临床分期和治疗程序  

The clinical stage and procedure of treatment for osteoradionecrosis of jaw

作　　者：姚小武[1] 李锐球[2] 

机构地区：[1]汕头大学医学院第二附属医院口腔科,515041 [2]第一军医大学南方医院口腔科

出　　处：《耳鼻咽喉（头颈外科）》2000年第3期152-154,共3页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：颌骨放射性骨坏死是头颈恶性肿瘤放射治疗的严重并发症，临床治疗十分困难。本文系统地总结了22例颌骨放射性骨坏死病例，提出临床分期和三阶段治疗程序。22例中3例因肿瘤局部复发停止治疗；5例经第一阶段治疗达到临床治愈；14例经三阶段的系统治疗后4例好转，10例临床治愈。作者认为，对颌骨放射性骨坏死的手术治疗应持积极态度，为保证手术的成功，术前术后有计划的进行高压氧治疗是必不可少的；手术成功的关键在于扩大截骨术，截骨范围应包括硬化区；抗感染＋高压氧治疗－扩大截骨术－术后高压氧治疗是颌骨放射性骨坏死较合理的治疗程序。Jaw osteoradionecrosis is one of the serious complications of radiotherapy for malignent tumors on head and neck region,and very difficult in treatment. T wenty-two patients of jaw osteoradionecrosis were assessed systematically,the clinical stage and treatment procedure of three phases were put forward in this paper. In these patients, 3 stopped treatment because of recurrence of carcinoma, 5 were cured after the first phase treatment, 14 received three phases treatment,with the result that 10 patients were cured and 4 patients improved with the disappearance of clinical signs. The author believed that it should be enthusiatic in operative treatment for the jaw osteoradionecrosis and absolutely necessary for hyperbaric oxygen treatment before and after the operation to ensure success. The key to the successful operation was a expanding osteoctomy which included the sclerosis region. Anti-infection+hyperbaric oxygen treatment-expanding osteoctomy-hyperbaric oxygen treatment postoperatively was an effective procedure of treatment for jaw osteoradionecrosis.

关 键 词：颌肿瘤 颌骨放射性骨坏死 放射疗法 治疗 

分 类 号：R730.5[医药卫生—肿瘤]