精囊内镜用于诊断和治疗11例阻塞性唾液腺疾病的效果评价  

Clinical application of seminal vesicle speculum in diagnosis and treatment of 11 patients with obstructive salivary gland disease

作　　者：王少如 高健刚 徐竹青 陈正岗[2] 郑建金[2] 邱建忠[2] 袁荣涛[2] 周建华[2] WANG Shao-ru;GAO Jian-gang;XU Zhu-qing;CHEN Zheng-gang;ZHENG Jian-jin;QIU Jian-zhong;YUAN Rong-tao;ZHOU Jian-hua(School of Stomatology,Dalian Medical University,Dalian 116044,Liaoning Province;Department of Stomatology,Qingdao Municipal Hospital,Qingdao University,Qingdao 266071,Shandong Province;Department of Urology,Qingdao Municipal Hospital,Qingdao University,Qingdao 266071,Shandong Province;School of Stomatology,Qingdao University,Qingdao 266000,Shajidong Province,China)

机构地区：[1]大连医科大学口腔医学院,辽宁大连116044 [2]青岛大学附属青岛市市立医院口腔医学中心,山东青岛266071 [3]青岛大学附属青岛市市立医院泌尿外科,山东青岛266071 [4]青岛大学口腔医学院,山东青岛266000

出　　处：《中国口腔颌面外科杂志》2020年第6期544-547,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：青岛市优秀青年人才计划。

摘　　要：目的:探讨精囊内镜用于阻塞性唾液腺疾病诊断和治疗的可行性及疗效。方法:选取2018年10月—2019年7月青岛大学附属青岛市市立医院口腔颌面外科收治的11例阻塞性唾液腺疾病患者,其中腮腺3例,下颌下腺8例。术前通过CT检查判断有无结石及其数目、位置和大小。全麻下应用精囊内镜在直视下观察导管壁及导管内的变化,明确发病原因,并进行相应治疗和评价疗效。结果:术前CT检查3例腮腺和1例下颌下腺未见明显结石影像;7例下颌下腺可见导管内单发或多发性高密度结石影。10例患者成功应用精囊内镜取出结石,或利用导管扩张、灌洗,去除黏液栓子后,阻塞症状消失;1例因导管口狭窄明显,附加口底小切口,引入腔镜进行取石。术后6~12个月随访均无阻塞症状复发。结论:精囊内镜可用于阻塞性唾液腺疾病的诊断和治疗,可部分替代涎腺镜的功能,属于一种创新性微创治疗方案。PURPOSE:To investigate the feasibility and curative effect of use of seminal vesicle speculum for diagnosis and treatment of obstructive salivary gland diseases.METHODS:Eleven patients diagnosed with obstructive salivary gland diseases from October 2018 to July 2019 in the Department of Oral and Maxillofacial Surgery of Qingdao Municipal Hospital Affiliated to Qingdao University were collected.All patients underwent preoperative CT examinations to quire detailed information of the number,location and size of stones.The intraductal features in salivary gland were directly observed by seminal vesicle endoscopy under general anesthesia and simultaneous removal of the obstructive objects.Postoperative efficacy was observed and evaluated.RESULTS:Preoperative CT examinations showed no calculi in 3 cases of parotid gland and 1 cases of submandibular gland,single or multiple intramedullary dense stone shadows were found in 7 cases of submandibular gland.In 10 patients,obstruction disappeared after removing the calculi or catheter dilation and lavage with seminal vesicle.In one case with obvious stenosis of the catheter orifice,a small incision was added at the floor of mouth to take the calculi.No symptom recurred during the follow-up of 6 to 12 months after operation.CONCLUSIONS:Seminal vesicle speculum can be used for diagnosis and treatment of obstructive salivary gland diseases,which can partially replace the function of sialoendoscopy as an innovative minimally invasive treatment.

关 键 词：阻塞性唾液腺疾病 精囊内镜 涎腺镜 涎石症 慢性阻塞性腮腺炎 

分 类 号：R782.7[医药卫生—口腔医学]