涎腺内窥镜诊断治疗慢性阻塞性涎腺炎的临床研究  

CLINICAL APPLICATION OF SIALENDOSCOPY IN THE DIAGNOSIS,AND TREATMENT OF CHRONIC OBSTRUCTIVE SIALADENITIS

作　　者：祁森荣[1] 王松灵[1] 李静远[1] 

机构地区：[1]首都医科大学口腔医学院涎腺疾病中心

出　　处：《北京口腔医学》2004年第1期38-42,共5页Beijing Journal of Stomatology

基　　金：国家自然科学基金资助 (编号 30 1 70 2 5 4 );首都医学发展科研基金资助 ;基金号 2 0 0 2 2 0 1 3

摘　　要：目的 :探讨涎腺内窥镜诊治慢性阻塞性涎腺炎的临床应用价值。方法 :对 30例有不明原因涎腺反复肿胀病史的患者 ,进行临床检查、x线平片、B超检查 ,对其中 2 2例排除涎石症的患者进行涎腺造影和涎腺内窥镜检查 ,比较所得结果。对此 2 2例患者应用涎腺内窥镜进行扩张狭窄导管及冲洗治疗 ,评价涎腺内窥镜疗效。结果 :30例患者x线平片发现阳性结石 8例。 2 2例涎腺造影检查 1 8例为慢性阻塞性涎腺炎造影表现 ,4例基本正常 ,未发现阴性结石。 2 2例涎腺内窥镜检查导管内皆可见纤维样物质、管壁上可见充血点少数出血点、导管口及附近 1cm左右较后方狭窄。 2 2例患者导管兼有狭窄和扩张。 5侧粘液栓子。 1侧阴性结石。追踪观察 1～ 8个月 ,平均 5个月 ,2 2例患者中 2 1例患者术后症状明显缓解 (有效率 95 % ) ,只有 4例患者复发 (复发率 1 8% ) ,但程度及持续时间较前明显减低。结论 :涎腺内窥镜能够直接准确诊断导管内阻塞原因 ,是一种结合了保守疗法和手术疗法优点的有效的诊治合一的微创治疗方法。Object:To evaluate the diagnosis and treatment value of sialendoscopy for chronic obstructive sialadenitis(COS).Methods:This study included 30 patients with a long history of recurrent swelling and pain in the involved glands,usually aggravated by eating.All patients were examined by X ray,ultrasound,sialograghy.Sialendoscopy was used in the 22 patients without sialolithiasis.Treatment effect was followed up for 5 months on average.Results:Sialendoscopy was performed in 22 patients with COS.Eight patients were diagnosed as sialolithiasis,and did not get sialendoscopy treatment.Fiber like substances connected with wall of ducts were found in all 22 patients.Sphincterlike structure in ostium and first centimeter of duct were noted in the 22 patients.All 22 patients were treated by dilation of stenosis and irrigation of ductal system with sialendoscopy.Follow up observation showed that effective rate was 95% in the treated patients,recurrent swelling attacked in 4 patients(18%).Conclusions:Sialendoscopy provided direct and reliable diagnosis of the pathological changes in ductal system compared with X ray,ultrasound,sialograghy.Good therapy effect was observed by dilation and irrigation of ductal system with sialendoscopy.

关 键 词：慢性阻塞性涎腺炎 内窥镜检查 微创治疗 影像学检查 诊断 

分 类 号：R781.72[医药卫生—口腔医学]