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目的:探索防治放射性颌骨骨髓炎的有效措施。方法:通过对37例放射性颌骨骨髓炎临床病例资料回顾性的总结,对其年龄、性别、病种分类、放射剂量、临床表现、发生因素及诊治方法进行研究分析。结果:1.本组病例放疗后均出现严重的口干症,以及龋病与牙周病。2.鼻咽癌患者放疗后骨髓炎病变多发生在上颌骨后牙区及下颌骨升支区,并伴有严重的张口受限。3.口腔癌患者放疗后的病变区多发生在下颌骨体部,出现严重的牙周病及根尖周病。结论:放疗前后加强口腔健康维护,积极防治牙体牙周疾病,增加唾液分泌措施的应用,坚持张口训练等,可降低放射性颌骨骨髓炎的发生或病变程度。手术清除死骨和病灶牙是放射性颌骨骨髓炎治疗的最有效措施。而精确放疗技术的应用可大大降低放射治疗并发症的发生。
Objective: To explore effective measures to prevent and treat radiosalcombing osteomyelitis. Methods: The clinical data of 37 cases of radiated maxillofacial osteomyelitis were retrospectively reviewed, and their age, sex, disease classification, radiation dose, clinical manifestations, causes and diagnosis and treatment methods were analyzed. Results: 1. This group of patients after radiotherapy have severe dry mouth, as well as dental caries and periodontal disease. Nasopharyngeal cancer patients with osteomyelitis lesions occurred in the maxillary posterior teeth and mandibular ascending branch area, accompanied by severe mouth restriction. 3. Oral cancer patients after radiotherapy lesions occurred in the mandibular body, a serious periodontal disease and periapical disease. Conclusions: Preoperative and postoperative radiotherapy to strengthen the oral health maintenance, prevention and treatment of periodontal disease, increase the application of salivary secretion measures, adhere to mouth opening training, can reduce the incidence of oropharyngeal osteomyelitis or lesion. Surgical removal of sequestrums and lesions of the teeth is the most effective treatment of radiation osteomyelitis. The application of precise radiotherapy technology can greatly reduce the incidence of radiation therapy complications.