头颈部恶性肿瘤患者治疗后张口困难的研究进展  

Research progress on posttreatment trismus in malignant head and neck tumors

作　　者：吴昊 周子疌 张成瑶 沈淑坤[2] 刘剑楠[2] 张陈平[2] WU Hao;ZHOU Zijie;ZHANG Chengyao;SHEN Shukun;LIU Jiannan;ZHANG Chenping(Weifang Medical University,College of Stomatology,Weifang 261000,China;Department of Oral MaxillofacialHead and Neck Oncology,Shanghai Ninth People's Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]潍坊医学院口腔医学院,山东潍坊261000 [2]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《口腔疾病防治》2021年第7期490-495,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：上海市卫生系统优秀人才培养计划项目(2018YQ34);上海交通大学“转化医学交叉研究基金”重点项目(ZH20182DA15);上海交通大学医学院附属第九人民医院青年医师协同创新团队项目(QC201901)。

摘　　要：头颈部恶性肿瘤严重威胁患者的身心健康,以手术为主的综合序列治疗常造成面部畸形、咀嚼吞咽困难和语音不清等多种并发症,而张口困难是头颈部恶性肿瘤患者综合治疗后最为常见的并发症之一,严重者可出现牙关紧闭、进食困难,进而导致患者出现营养不良甚至恶病质,不仅影响患者生存质量,甚至危及生命,同时也会带来了严重的社会及经济负担。如何有效防治治疗后张口困难是口腔颌面外科医师容易忽视但亟待解决的临床问题。文献复习结果表明,张口困难发生率与肿瘤的临床分期、发病部位、治疗方法、放疗部位、放疗剂量、放疗方法等多种因素相关,张口困难的发生率在治疗后6个月较高,造成的功能障碍如不尽早干预,带来的后果会愈加严重。目前研究证明,张口困难的防治以控制张口受限的进展、恢复功能为主要原则,张口训练可显著改善头颈部恶性肿瘤患者治疗后的张口受限。Malignant tumors in the head and neck seriously threaten the physical and mental health of patients.After treatment,they may cause many complications,such as facial deformity,difficulties with chewing,dysphagia and asaphia.Among them,trismus(restricted mouth opening)is one of the most common complications after treatment of malignant oral-maxillofacial tumors.In severe cases,patients may even suffer from trismus and eating difficulties,finally leading to malnutrition and even cachexia.Therefore,it not only affects the quality of life of patients and even endangers their lives but also brings heavy social and economic burdens.How to effectively prevent and treat posttreatment trismus is a clinical problem that is easily ignored by head and neck surgeons and urgently needs to be solved.The results of a literature review showed that trismus may be related to the tumor clinical stage,tumor site,treatment used,radiotherapy site,radiotherapy dose,radiotherapy type,and other factors.The incidence of trismus tends to be significant 6 months after treatment.Without early intervention,the resulting dysfunction may become more severe.Current studies have shown that the prevention and treatment of restricted mouth opening is based on controlling the progress of restricted mouth opening and restoring function.Exercise intervention for trismus can significantly improve the restricted mouth opening of patients with malignant head and neck tumors after treatment.

关 键 词：头颈部恶性肿瘤 综合序列治疗 张口困难 张口训练 最大张口度 Thera Bite■运动康复系统 

分 类 号：R78[医药卫生—口腔医学]