口面部肉芽腫的診治進展和臨床病例報道
發(fā)布時間：2018-11-03 11:37
【摘要】：[目的]初步探討口腔病灶在口面部肉芽腫發(fā)病及治療中的作用,并對口面部肉芽腫的發(fā)病病因、臨床表現(xiàn)、診斷、鑒別診斷、治療、預(yù)后轉(zhuǎn)歸等相關(guān)研究進展和報道作一綜述,為以后口面部肉芽腫的臨床診治提供一定參考。[方法]收集2014年7月至2017年2月在山東大學(xué)口腔醫(yī)院粘膜科就診的42例口面部肉芽腫患者,其中男性20例,女性22例,年齡為15-69歲,且均排除明顯系統(tǒng)性疾病,如糖尿病、高血壓、心臟病等。唇部腫脹者40例,其中上唇腫脹者6例,下唇腫脹者10例,雙唇腫脹者7例,唇部腫脹伴有面癱或裂舌者3例,唇部腫脹伴有唇或頰部結(jié)節(jié)樣改變者12例,唇部腫脹伴有牙齦等其他部位不典型表現(xiàn)者2例;頰部結(jié)節(jié)樣改變者2例。對此我們采取了不同的治療方法,去除口腔病灶均取得了良好地效果。[結(jié)果]42例口面部肉芽腫患者中存在慢性根尖炎者40例,牙周炎者15例,冠周炎者4例,慢性牙髓炎者3例,其中單純存在慢性根尖炎者20例,單純存在牙周炎者1例,單純存在冠周炎者1例,存在慢性根尖炎合并牙周炎者14例,存在慢性根尖炎合并冠周炎者3例,存在慢性根尖炎合并慢性牙髓炎者3例。去除口腔病灶,如根管治療、拔除患牙、牙周治療、必要的根尖手術(shù)等后,臨床治愈者25例,癥狀減輕者17例,進一步治療如應(yīng)用抗組胺藥、沙利度胺、局部應(yīng)用他克莫司等后患者癥狀基本痊愈,取得了較好的臨床效果。[結(jié)論]口面部肉芽腫是一種由多種病因引起的口面部的慢性腫脹和肉芽腫性炎癥性疾病。它的病因不明確,可疑與遺傳因素、過敏、免疫及感染因素有關(guān),而口腔中的病灶如慢性根尖炎、牙周炎、冠周炎、慢性牙髓炎等作為重要的感染因素,對口面部肉芽腫的發(fā)生發(fā)展起著重要的作用。它的臨床表現(xiàn)多種多樣,但以唇部腫脹為特征的肉芽腫性唇炎為最常見表現(xiàn)。它的診斷較為復(fù)雜,仔細的臨床檢查、影像學(xué)輔助檢查及必要的組織病理學(xué)檢查可幫助口面部肉芽腫的正確診斷,需與多種系統(tǒng)性疾病相鑒別,如結(jié)節(jié)病、克羅恩病等。它的治療多采取非手術(shù)治療的方法,對因及對癥治療。對于存在明確口腔病灶的患者早期正確的診斷,盡早去除病灶,患者預(yù)后一般較好。
[Abstract]:[objective] to explore the role of oral lesions in the pathogenesis and treatment of oral and facial granuloma, and to analyze the etiology, clinical manifestations, diagnosis, differential diagnosis and treatment of oral and facial granuloma. The progress and reports of prognosis and prognosis are reviewed, which provides a reference for the clinical diagnosis and treatment of oral and facial granuloma. [methods] from July 2014 to February 2017, 42 patients with oral and facial granulomatosis were collected, including 20 males and 22 females, aged 15-69 years, all of whom were excluded from obvious systemic diseases. Such as diabetes, high blood pressure, heart disease and so on. There were 40 cases of lip swelling, including 6 cases of upper lip swelling, 10 cases of lower lip swelling, 7 cases of double lip swelling, 3 cases of lip swelling with facial paralysis or fissure of tongue, 12 cases of lip swelling with nodular changes of lip or buccal region. There were 2 cases of labial swelling accompanied by atypical manifestations of other parts such as gingiva. Nodular changes in the buccal region were found in 2 cases. We have adopted different treatment methods and achieved good results in removing oral lesions. [results] there were 40 cases of chronic apical inflammation, 15 cases of periodontitis, 4 cases of pericoronitis and 3 cases of chronic pulpitis in 42 patients with oral and facial granuloma. There were only 1 case of pericoronitis, 14 cases of chronic apical periodontitis, 3 cases of chronic apical periodontitis and periodontitis, 3 cases of chronic apical periodontitis and chronic pulpitis. After removal of oral lesions, such as root canal therapy, extraction of teeth, periodontal treatment and necessary apical surgery, 25 cases were clinically cured and 17 cases were relieved of symptoms. Further treatment such as antihistamine, thalidomide, etc. After local application of tacrolimus, the symptoms of the patients were basically cured and good clinical results were obtained. Conclusion Oral and facial granuloma is a chronic swelling and granulomatous inflammatory disease caused by many causes. The etiology of the disease is not clear, and is suspected to be related to genetic factors, allergies, immunity and infection, while oral lesions such as chronic apical periodontitis, pericoronitis, chronic pulpitis, etc., are important infectious factors. The occurrence and development of facial granuloma plays an important role. Its clinical manifestations are varied, but granulomatous lipitis characterized by swelling of the lip is the most common manifestation. Its diagnosis is more complicated. Careful clinical examination, imaging auxiliary examination and necessary histopathological examination can help the correct diagnosis of oral and facial granuloma, and should be distinguished from many systemic diseases, such as sarcoidosis, Crohn's disease, etc. Its treatment takes the method of non-surgical treatment, for the cause and symptomatic treatment. For patients with definite oral lesions, early diagnosis and early removal of lesions, the prognosis of patients is generally good.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R758.6
本文編號：2307673
[Abstract]:[objective] to explore the role of oral lesions in the pathogenesis and treatment of oral and facial granuloma, and to analyze the etiology, clinical manifestations, diagnosis, differential diagnosis and treatment of oral and facial granuloma. The progress and reports of prognosis and prognosis are reviewed, which provides a reference for the clinical diagnosis and treatment of oral and facial granuloma. [methods] from July 2014 to February 2017, 42 patients with oral and facial granulomatosis were collected, including 20 males and 22 females, aged 15-69 years, all of whom were excluded from obvious systemic diseases. Such as diabetes, high blood pressure, heart disease and so on. There were 40 cases of lip swelling, including 6 cases of upper lip swelling, 10 cases of lower lip swelling, 7 cases of double lip swelling, 3 cases of lip swelling with facial paralysis or fissure of tongue, 12 cases of lip swelling with nodular changes of lip or buccal region. There were 2 cases of labial swelling accompanied by atypical manifestations of other parts such as gingiva. Nodular changes in the buccal region were found in 2 cases. We have adopted different treatment methods and achieved good results in removing oral lesions. [results] there were 40 cases of chronic apical inflammation, 15 cases of periodontitis, 4 cases of pericoronitis and 3 cases of chronic pulpitis in 42 patients with oral and facial granuloma. There were only 1 case of pericoronitis, 14 cases of chronic apical periodontitis, 3 cases of chronic apical periodontitis and periodontitis, 3 cases of chronic apical periodontitis and chronic pulpitis. After removal of oral lesions, such as root canal therapy, extraction of teeth, periodontal treatment and necessary apical surgery, 25 cases were clinically cured and 17 cases were relieved of symptoms. Further treatment such as antihistamine, thalidomide, etc. After local application of tacrolimus, the symptoms of the patients were basically cured and good clinical results were obtained. Conclusion Oral and facial granuloma is a chronic swelling and granulomatous inflammatory disease caused by many causes. The etiology of the disease is not clear, and is suspected to be related to genetic factors, allergies, immunity and infection, while oral lesions such as chronic apical periodontitis, pericoronitis, chronic pulpitis, etc., are important infectious factors. The occurrence and development of facial granuloma plays an important role. Its clinical manifestations are varied, but granulomatous lipitis characterized by swelling of the lip is the most common manifestation. Its diagnosis is more complicated. Careful clinical examination, imaging auxiliary examination and necessary histopathological examination can help the correct diagnosis of oral and facial granuloma, and should be distinguished from many systemic diseases, such as sarcoidosis, Crohn's disease, etc. Its treatment takes the method of non-surgical treatment, for the cause and symptomatic treatment. For patients with definite oral lesions, early diagnosis and early removal of lesions, the prognosis of patients is generally good.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R758.6
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