[多发性骨髓瘤中与双膦酸盐使用相关的颌骨骨坏死：4例报告及文献复习]
[Osteonecrosis of the jaw associated with the use of bisphosphonates in multiple myeloma: report of four cases and literature review].
作者信息
Li Li-hong, Wu Xue-bin, Chen Wen-ming, Chen Jian-xin, Wu Yin, Chen Shi-lun
机构信息
Department of Hematology, Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2008 Nov 18;88(42):2986-7.
OBJECTIVE
To summarize the clinical features of osteonecrosis of the jaw (ONJ) in multiple myeloma (MM) patients treated with bisphosphonate.
METHODS
The clinical data of 4 patients with bisphosphonate-related (ONJ) in MM were reported and literatures were reviewed.
RESULTS
In these patients, 3 males and 1 female, aged 59-73, pamidronate combined with chemotherapy, high dose glucocorticosteroid, and anti-angiogenic drug had been used for 12-44 months before the occurrence of ONJ. In treatment of ONJ conservative debridement of necrotic bone, systematic use of antibiotics, use of chlorhexidine acetate gargle, and withdrawal of bisphosphonates were preferable to aggressive surgical measures.
CONCLUSION
Long-term use of bisphosphonates combined with chemotherapy in MM may cause ONJ that involves both mandible and maxilla. No satisfactory therapy is currently available.
目的
总结接受双膦酸盐治疗的多发性骨髓瘤（MM）患者颌骨坏死（ONJ）的临床特征。
方法
报告4例MM患者双膦酸盐相关ONJ的临床资料并复习文献。
结果
这些患者中，男性3例，女性1例，年龄59 - 73岁，在ONJ发生前，帕米膦酸联合化疗、大剂量糖皮质激素及抗血管生成药物已使用12 - 44个月。在ONJ治疗中，坏死骨保守清创、系统使用抗生素、使用醋酸氯己定含漱以及停用双膦酸盐优于积极的手术措施。
结论
MM患者长期使用双膦酸盐联合化疗可能导致累及下颌骨和上颌骨的ONJ。目前尚无满意的治疗方法。
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