华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

二膦酸盐相关性颌骨骨坏死的临床分析

龚佳幸  王慧明   

  1. 浙江大学医学院附属第一医院口腔颌面外科,杭州 310003
  • 出版日期:2016-08-01 发布日期:2016-08-01
  • 通讯作者: 王慧明,教授,博士,E-mail:hmwang1960@hotmail.com
  • 作者简介:龚佳幸,硕士,E-mail:46908398@qq.com
  • 基金资助:

    国家自然科学基金(81371120,81171003)

Clinical analysis of bisphosphonate-related osteonecrosis of the jaw

Gong Jiaxing, Wang Huiming   

  1. Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou 310003, China
  • Online:2016-08-01 Published:2016-08-01
  • Contact: Wang Huiming, E-mail: hmwang1960@hotmail.com
  • Supported by:

    The National Natural Science Foundation of China(81371120, 81171003)

摘要:

目的  研究药物性颌骨骨髓炎的临床特点。方法  分析2013年5月—2015年9月浙江大学附属第一医院口腔颌面外科收治的12例二膦酸盐相关性颌骨骨坏死患者的基本情况、长期用药史、出现颌骨骨髓炎时间、症状、诊治经过及疗效。结果  9例患者为下颌骨骨髓炎,3例患者为上颌骨骨髓炎。10例患者用药时间10~80个月不等,平均用药(28.00±21.42)个月。手术治疗9例,保守治疗3例:经手术治疗后创面愈合8例,骨暴露处于稳定状态1例;保守治疗患者目前定期换药。结论  静脉注射二膦酸盐类药物可导致药物性颌骨骨髓炎,下颌骨较多见,拔牙为一大诱因。目前的治疗手段多以缓解疼痛和提高生活治疗为目的,故该疾病的预防尤为重要。

关键词: 二膦酸盐, 颌骨, 骨髓炎, 骨坏死

Abstract:

Objective  The study aims to analyze patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Methods  Twelve patients treated in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Medical School, Zhejiang University from May 2013 to September 2015 were included. Patients’ basic situation, medication, clinical symptoms, therapies, and effects were obtained and analyzed. Results  The treatment of nine patients focused on the mandible, whereas that of three patients was on the maxilla. The clinical symptoms appeared from 10 to 80 months, with an average of about (28.00±21.42) months. Nine patients had tooth extraction history. After operation (nine patients), eight were treated, one had stable in bone exposure and three patients received conservative treatment. Conclusion  Intravenous infusion of bisphosphonates can induce BRONJ. The mandible is commonly involved and tooth extraction is a big inducement. Treatments nowadays seek to relieve clinical symptoms, but prevention is more important.

Key words: bisphosphonate, jaws, osteomyelitis, osteonecrosis