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双膦酸盐类药物相关颌骨坏死是双膦酸盐类药物一种潜在的严重副反应,发生率从0到28%不等。以患者出现缺血性骨坏死和骨暴露为典型特征,伴有明显疼痛、颌面部瘘管、甚至病理性骨折,极大地影响患者的生活质量和相关的治疗。其发病因素涉及药物本身的药理作用、创伤因素、感染因素、以及可能的致病基因带来的易感性,发病机制较为复杂。该病的治疗方法种类较多,包括全身使用抗生素、局部冲洗和含漱、手术治疗、高压氧舱、激光、自体骨髓干细胞移植等,但无一能够达到非常有效的治疗效果。本文就双膦酸盐类药物相关颌骨坏死的发病机制、临床治疗的相关研究进展进行文献综述。
Bisphosphonates-related osteonecrosis is a potentially serious side effect of bisphosphonates, with rates ranging from 0 to 28%. In patients with ischemic necrosis and bone exposure as a typical feature, with significant pain, maxillofacial fistula, and even pathological fractures, which greatly affect the quality of life of patients and related treatment. The pathogenesis of the drug itself involves pharmacological effects, traumatic factors, infectious factors, and possible pathogenic genes caused by the susceptibility, the pathogenesis is more complicated. There are many types of treatments for this disease, including systemic antibiotics, local irrigation and gargle, surgical treatment, hyperbaric oxygen chamber, laser, autologous bone marrow stem cell transplantation, but none of them can achieve very effective treatment. This article reviews the literature review on the pathogenesis of bisphosphonate-related jaw necrosis and related research progress in clinical treatment.