药物相关性颌骨骨坏死：文献回顾与6例病例报告

发布时间：2018-06-02 14:22

本文选题：药物相关性颌骨骨坏死 + 二磷酸盐　；参考：《浙江大学》2017年硕士论文

【摘要】：药物相关性颌骨骨坏死(Medication related osteonecrosis of the jaw,MRONJ)主要是由二磷酸盐类药物,狄诺塞麦以及抗血管类药物引起的一类疾病,其中以二磷酸盐类药物为主。该类药物在20世纪末期被广泛用于治疗异常的骨代谢,尤其是骨转移癌、血源性恶性肿瘤以及骨质疏松。二磷酸盐类药物一直被认为是十分安全的,因此其使用量持续增加,直至2003年二磷酸盐相关性颌骨坏死病例被首次报道。在全球范围内,具有MRONJ症状的患者正在不断增加。MRONJ的发生起始包括多种原因,药物的种类,给药方式,原发疾病,宿主情况,口腔情况,发病部位等均是导致该疾病的风险因素。美国颌面外科协会(The American Association of Oral and Maxillofacial Surgeons,AAMOS)对该疾病的临床管理进行了系统的阐述,同时许多学者也展开了对该疾病的研究。本文将对该疾病的发病机理,流行病学,致病因素,临床特征,诊断依据,临床处理指南以及最新治疗研究进展进行文献复习,旨在能对该疾病能有更为系统全面地了解。同时,依据AAMOS提出的诊断标准,收集经临床检查及影像学检查后被临床诊断为药物相关性颌骨骨坏死的患者6例。依据AAMOS的临床处理指南对这6名患者行相应的治疗,分析总结该指南的临床有效性。
[Abstract]:Drug-associated related osteonecrosis of the jawawnjm (MRONJ) is a kind of disease mainly caused by diphosphates, dinosemide and antivascular drugs, among which diphosphates are the main ones. These drugs were widely used in the late 20th century for the treatment of abnormal bone metabolism, especially bone metastases, hematogenous malignancies and osteoporosis. Bisphosphates have been considered to be safe, so their use has been increasing until 2003, when diphosphate related osteonecrosis of jaws was reported for the first time. Globally, the number of patients with MRONJ symptoms is increasing. MRONJ starts with multiple causes, types of drugs, drug delivery, primary diseases, host conditions, oral conditions, The location of the disease is the risk factor of the disease. The American Association of Maxillofacial Surgeons (American Association of Oral and Maxillofacial SurgeonsAAM Amos) has systematically described the clinical management of the disease, and many scholars have also carried out research on the disease. This article reviews the pathogenesis, epidemiology, pathogenic factors, clinical characteristics, diagnostic basis, clinical management guidelines and the latest research progress of treatment of the disease, in order to have a more systematic and comprehensive understanding of the disease. At the same time, according to the diagnostic criteria proposed by AAMOS, 6 patients were clinically diagnosed as drug-related osteonecrosis of jaws after clinical and imaging examinations. According to the clinical treatment guidelines of AAMOS, 6 patients were treated, and the clinical effectiveness of the guidelines was analyzed and summarized.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782

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