开窗刮治术治疗24例下颌骨实性成釉细胞瘤效果观察  

Clinical analysis of intraosseous curettage combined with decompression in the treatment of mandibular solid ameloblastoma: report of 24 consecutive cases

作　　者：贺捷[1] 田卓炜 胡永杰[1] 王延安[1] HE Jie;TIAN Zhuo-wei;HU Yong-jie;WANG Yan-an(Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology.Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,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200011

出　　处：《中国口腔颌面外科杂志》2021年第3期258-261,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(31400859);上海市自然科学基金(19ZR1429900);上海市卫生与计划生育委员会基金面上项目(201840021)。

摘　　要：目的:观察下颌骨实性成釉细胞瘤一期刮治开窗术结合二期刮治术的临床效果,探讨该术式治疗下颌骨实性成釉细胞瘤的可行性。方法:筛选24例下颌骨单房或多房实性肿瘤患者,术中明确诊断为成釉细胞瘤后,进行一期开窗刮治。术后定期随访颌面部CT、全景片,适时行二期刮治。观察囊腔变化,分析治疗效果。结果:24例患者中,无肿瘤进展、范围增大病例,均未出现开窗口早闭、局部感染或骨髓炎症状。其中病情稳定6例,部分缓解10例,完全缓解8例,总有效率为75.0%。20例患者经二期刮治术,术后随访12~24个月,未见肿瘤复发。结论:开窗刮治治疗下颌骨实性成釉细胞瘤具有可行性,但应严格掌握手术适应证。PURPOSE: To evaluate the effect of intraosseous curettage combined with decompression using for mandibular solid ameloblastoma treatment. METHODS: Twenty-four cases with unilocular or multilocular solid ameloblastoma of the mandible received intraosseous curettage combined with decompression from Jan. 2017 to Dec. 2018. The primary e-valuation parameter was the percentage of the residual cyst area within 1-year follow-up after surgery. RESULTS: A total of 24 cases were included in this study. After 12-24 months of consecutive follow-up, the tumor cavities shrank to differ-ent extent without recurrence and osteogenesis was good. Compared with preoperative panorama and CT scan, six cases were ranked as no response(stable), ten were partial response and the remaining eight cases were classified as complete response. The overall efficiency was 75.0%. CONCLUSIONS: Intraosseous curettage combined with decompression is an effective therapeutic method for solid ameloblastoma of the mandible.

关 键 词：开窗刮治术 下颌骨 实性成釉细胞瘤 

分 类 号：R739.8[医药卫生—肿瘤]