53例二磷酸盐相关颌骨坏死诊治的回顾性分析  

The retrospective analysis of 53 patients with bisphosphonaterelated osteonecrosis of the jaw

作　　者：李银柱[1] 徐文君[2] 崔景英[2] 任翠爱[2] 

机构地区：[1]潍坊医学院 [2]潍坊市人民医院血液科,山东潍坊261000

出　　处：《山东大学学报（医学版）》2013年第1期109-112,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨二磷酸盐导致的颌骨坏死的临床表现和治疗进展。方法对2005～2011年间收治的53例二磷酸盐相关颌骨坏死(BRONJ)的多发性骨髓瘤(MM)患者临床特点、诊断和治疗方法进行回顾性分析总结。结果 53例患者均接受了抗生素治疗,其中12例进行了骨清创术/姑息性手术治疗,12例给予骨清创术/姑息性手术联合臭氧治疗,14例给予臭氧治疗。联合臭氧治疗26例,非联合臭氧治疗27例。单用抗生素治疗有效率为60.0%,抗生素联合手术有效率为58.4%,联合臭氧组治疗有效率为92.3%,非联合臭氧组治疗有效率为59.2%。结论在BRONJ中抗生素能控制疾病进展,抗生素联合手术治疗较单用抗生素治疗的有效率并没有明显增高,并且会影响患者生活质量,在BRONJ患者中建议保守治疗。另外,臭氧治疗较其他治疗有效率明显增高,建议临床推广应用。Objective To explore the clinical manifestations and treatments of bisphosphonate-related osteonecrosis of the jaw. Methods The clinical manifestations diagnostic and treatments of 53 multiple myeloma cases of bisphospho- nate-related osteonecrosis of the jaw admitted to our hospital between 2005-2011 were analyzed retrospectively. Results 53 patients were all treated with antibiotics. 12 patients of them were performed with bone debridement/palliative sur- geries, 12 patients were performed with bone debridement/palliative surgeries in association with ozone treatment and 14 patients were performed with ozone treatment. 26 patients were performed in association with ozone treatment, 27 pa- tients weren＇ t performed in association with ozone treatment. The efficient treated with antibiotics alone was 60%, the antibiotic therapy in association with surgeries was 58.4%, in association with ozone treatment was 92.3%, no ozone treatment was 59.2%. Conclusion Antibiotics can control disease progression in BRONJ patients, the remission rate treated by antibiotics combined with surgeries is not significantly higher than that treated by antibiotics alone, and will affect the quality of life of patients. We recommend conservative treatment in BRONJ patients. In addition, ozone treat- ment, compared with other treatments, has significantly higher efficiency, so its clinical application is proposed.

关 键 词：二磷酸盐 颌骨坏死 抗生素 骨清创术 姑息性手术 臭氧治疗 

分 类 号：R733.3[医药卫生—肿瘤]