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題 名 | 以高壓氧為輔助性療法治療顏面骨放射性骨壞死之臨床經驗 |
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作 者 | 陳明庭; 潘坤地; 洪學義; 楊永健; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷 期 | 3:2 1994.06[民83.06] |
頁 次 | 頁75-82 |
分類號 | 416.413 |
關鍵詞 | 放射性骨壞死; 口腔癌; 輔助治療; 高壓氧; Osteoradionecrosis; Oral cancer; Adjuvant therapy; Hyperbaric oxygen; |
語 文 | 中文(Chinese) |
中文摘要 | 頭頸部的惡性腫瘤,經過放射線治療之後,有5-22%的機率發生放射性骨壞死。以往經過積極的清創及藥物治療,時常無法達到有效的治癒。從1988年1月到1992年12月增加高壓氣作為輔助性治療之後,我們成功的治癒了59個放射線骨壞死的病例。在全部71位病中,除了12位因為無法適應,沒有繼續接受高壓氣治療外,剩下的59人(83.2%)都得到復癒。其中依照Marx分類stageⅠ有33位(占46.8%),在高壓氣的輔助下,將傷口局部清創,就得到癒合的效果。StageⅡ有5位(占7.0%)而StageⅢ有21位(占29.4%),須經過比較複雜的治療,包括高壓氣治療、局部傷口清創加上局部皮辦(local flap)或自由皮辦(free flap)的重建。這種經過高壓氣艙來增加組織氣分壓,已經證實可以形成新膠原、以及血管增生^1。使「放射性骨壞死」這種令臨床醫師頭痛的問題,能夠得到滿意的治療成效。 |
英文摘要 | Osteoradionecrosis of mandible or maxilla is often a late complication of radiotherapy for cancer of oral cavity. It occurred 6 months to 8 years after the radiotherapy in our series. During 4 years period from 1988 to 1992 we have treated 71 cases of post irradiated osteoradionecrosis of facial bone. The main therapeutic regimen were local irrigation, repeated aggressive surgical debridement, antibiotics and adjuvant hyperbaric oxygen therapy. Antibiotics may be given in acute inflammatory stage, HBO accelerates vascular proliferation and stimulates osteogenesis also can be employed as a bacteriostatic or bacteriocidal, particularly for these fastidious Gram negative and anaerobic resistant strain microorganisms. By treatment of 20dives 46.8% obtained cure, and by 60 dives 66.4% obtained cure, 16.8% of our cases need to exceed more than 60 dives in order to reach the status of symtom free. By the document of clinical symptoms and radiographic examination, HBO has been proved to be essential and effective adjuvant treatment for the osteoradionecrosis. |
本系統中英文摘要資訊取自各篇刊載內容。