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胰凝乳蛋白酶联合唾液腺内镜辅助手术治疗慢性阻塞性腮腺炎。

Chymotrypsin with sialendoscopy-assisted surgery for the treatment of chronic obstructive parotitis.

作者信息

Sun H-J, Xiao J-Q, Qiao Q-H, Bao X, Wu C-B, Zhou Q

机构信息

Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, China; Liaoning Institute of Dental Research, Shenyang, Liaoning Province, PR China.

Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, China; Liaoning Institute of Dental Research, Shenyang, Liaoning Province, PR China.

出版信息

Int J Oral Maxillofac Surg. 2017 Jul;46(7):877-882. doi: 10.1016/j.ijom.2017.02.1267. Epub 2017 Mar 6.

Abstract

Chronic obstructive parotitis (COP) is a common disease of the parotid gland. A total of 104 patients with COP were identified and randomized into a treatment group (52 cases) and a control group (52 cases). All patients underwent sialography and salivary gland scintigraphy (SGS) examinations before surgery. The patients in the treatment group received chymotrypsin combined with gentamicin via interventional sialendoscopy to irrigate the duct, and the control group received gentamicin alone. All patients were asked to record their pain on a visual analogue scale (VAS) before treatment and at 1 week, 2 weeks, 1 month, 3 months, and 6 months after surgery. The VAS score for pain intensity was decreased at 1 week post-treatment in both groups (P<0.05). Compared to the control group, the VAS score was lower in the treatment group at 1 week, 2 weeks, and 1 month post-treatment (P<0.05). The 6-month postoperative SGS results showed improved uptake and excretion in both groups (P<0.05). The treatment group exhibited higher scores for postoperative SGS excretion than the control group (P<0.05). The administration of chymotrypsin combined with gentamicin by sialendoscopy is effective for the treatment of non-stone-related COP and specifically improves the excretion function of the parotid gland.

摘要

慢性阻塞性腮腺炎(COP)是腮腺的一种常见疾病。共纳入104例COP患者,随机分为治疗组(52例)和对照组(52例)。所有患者在手术前均接受了唾液腺造影和唾液腺闪烁扫描(SGS)检查。治疗组患者通过介入性唾液腺内镜接受糜蛋白酶联合庆大霉素冲洗导管,对照组仅接受庆大霉素治疗。所有患者均被要求在治疗前以及术后1周、2周、1个月、3个月和6个月时采用视觉模拟评分法(VAS)记录疼痛情况。两组患者在治疗后1周时疼痛强度的VAS评分均降低(P<0.05)。与对照组相比,治疗组在治疗后1周、2周和1个月时的VAS评分更低(P<0.05)。术后6个月的SGS结果显示两组的摄取和排泄均有所改善(P<0.05)。治疗组术后SGS排泄评分高于对照组(P<0.05)。通过唾液腺内镜给予糜蛋白酶联合庆大霉素治疗非结石性COP有效,尤其可改善腮腺的排泄功能。

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