首页|骨管技术在Ⅱ期下颌骨药物相关性颌骨坏死手术中的应用初探

骨管技术在Ⅱ期下颌骨药物相关性颌骨坏死手术中的应用初探

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目的 探讨手术联合骨管技术在Ⅱ期下颌骨药物相关性颌骨坏死(MRONJ)治疗中的效果.方法 纳入2020年6月—2023年6月期间21例行手术治疗的Ⅱ期下颌骨MRONJ患者,回顾分析患者的临床资料(性别、年龄、原发疾病、药物名称及给药方式、术前是否停药和预后).其中男性14例,女性7例,发病时平均年龄为(68.33±10.74)岁.根据美国口腔颌面外科医师协会的指南对患者进行分期,纳入患者为Ⅱ期下颌骨MRONJ,治疗方式为颌骨部分切除术联合骨管技术,术中软组织无张力严密缝合.术后定期随访,并根据患者的临床表现及影像学检查等评价手术疗效.采用简版SF-12量表对所有患者进行术前和术后生活质量评价.结果 本组患者共21例,术后随访8~38个月,17例患者黏膜愈合良好(80.95%),临床伴随症状消失,无新的死骨形成.患者术后生活质量评分[(83.62±5.90)分]显著高于术前[(63.67±4.70)分](P<0.05).结论 手术联合骨管技术在较为难治的Ⅱ期MRONJ患者中是一种有效的治疗方法,成功率高.
Application of bone perforation in the surgery of medication-related osteonecrosis of the jaw in stageⅡ
Objective This study aimed to explore the effect of surgery combined with bone perforation for treating stage Ⅱ medication-related osteonecrosis of the jaw(MRONJ).Methods A total of 21 patients with stage Ⅱ mandibu-lar MRONJ who underwent surgical treatment from June 2020 to June 2023 were included in this study.Retrospective analysis was conducted on their clinical data,including gender,age,primary disease,drug name and administration meth-od,pre-surgery drug cessation,and prognosis.The cohort comprised 14 males and 7 females,with an average age at on-set of 68.33±10.74 years.According to the guidelines of the American Association of Oral and Maxillofacial Surgeons,the included patients had stage Ⅱ mandibular MRONJ.The treatment approach consisted of partial mandibulectomy combined with bone perforation techniques,ensuring tension-free suturing of soft tissues.Follow-up was performed reg-ularly,and the curative effect was evaluated.The SF-12 health survey was used to assess the quality of life for all pa-tients before and after surgery.Results A total of 21 patients were followed up for 8-38 months after surgery,and the mucosal healing of 17 patients was good(80.95%).The postoperative quality of life score(83.62±5.90)was sig-nificantly higher than that before operation(63.67±4.70,P<0.05).Conclusion Surgery combined with bone per-foration technique is an effective treatment method with high success rate in refractory stage Ⅱ MRONT patients.

mandiblemedication-related osteonecrosis of the jawsurgical treatmentpartial mandibulectomy

高娜、田美、孙亚威、王丹妮、孙国文

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南京大学医学院附属口腔医院·南京市口腔医院口腔颌面外科,南京大学口腔医学研究所,南京 210008

下颌骨 药物相关性颌骨坏死 手术治疗 颌骨部分切除术

南京市卫生科技发展专项资金项目

YKK22183

2024

华西口腔医学杂志
四川大学

华西口腔医学杂志

CSTPCD北大核心
影响因子:1.336
ISSN:1000-1182
年,卷(期):2024.42(5)