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題名 | 下頷骨放射性骨壞死:病例報告=Mandibular Bone Osteoradionecrosis: A Case Report |
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作者 | 陳志男; 劉博仁; 袁本治; Chen, Chih-nan; Liu, Po-jen; Yuan, Ben-chih; |
期刊 | 醫學研究 |
出版日期 | 19981100 |
卷期 | 19:3 1998.11[民87.11] |
頁次 | 頁185-190 |
分類號 | 416.8 |
語文 | chi |
關鍵詞 | 高壓氧治療; 下頷骨放射性骨壞死; Hyperbaric oxygen therapy; Mandibular bone osteoradionecrosis; |
中文摘要 | 下頜骨放射性骨壞死(mandibular bone osteoradionecrosis)為頭頸部惡性腫瘤放射治療後的並發症之一。雖然造成放射性骨壞死的機轉不明,但以Marx提出因放射線造成組織缺氧及慢性傷口組織癒合不良的理論(hypoxic-hypovascular-hypocellular tissue)最被廣泛接受。至於下頜骨放射性骨壞死的治療,雖然有學者主張用保守性療法;但漸多的研究報告顯示,最主要的治療需包括感染之控制、原發放射性骨壞死病灶之切除及高壓氧治療三方面。 本科於1997年3月經歷一例因鼻因癌放射治療後造成下頜骨放射性骨壞死,患者為75歲男性,1996年5月因鼻咽癌接受鈷六十(Co-60)放射治療,於次年發現左下頜骨放射性骨壞死而至本科求診,接受腐骨切除術(sequestrectomy)及抗生素治療,並安排接受高壓氧治療(hyperbaric oxygen therapy),病患出院後,於門診追蹤至今狀況穩定,無復發現象。 |
英文摘要 | Osteoradionecrosis (ORN) of the mandible is one of the complications after the use of radiotherapy in the treatment of malignant head and neck tumors. Although the pathogenesis of ORN of the mandible was not completely understood, Marx defined the sequence of events leading to ORN are: radiation, formation of hypoxic, hypovascular, and hypocellular tissue, followed by tissue breakdown, and resulting in a chronic non-healing wound. Some authors suggest a more conservative treatment, but many reports in recent literature suggest that treatment of ORN should include HBO, surgical debridement, and antibiotic therapy. The rate of resolution in these series is higher than in which HBO was used only and not in combination with surgery. In 1997, we experienced a 75-year-old man with osteoradionecrosis of the mandible after radiotherapy for NPC. A combination of surgical debridement, antibiotics, and hyperbaric oxygen gives good results. |
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