Rohart J, Bouillet L, Moizan H
Service d'odontologie, hôpital Saint-Julien, CHU de Rouen, 76031 Rouen, France; UDSL, université Lille Nord de France, 59000 Lille, France.
Centre national de référence des angiœdèmes, CHU de Grenoble, 38043 Grenoble cedex 09, France; Centre de référence des angiœdèmes, clinique universitaire de médecine interne, CHU de Grenoble, 38043 Grenoble cedex 09, France; Unité Inserm 1036, CEA-Grenoble, université Grenoble-Alpes, 38054 Grenoble cedex 09, France.
J Stomatol Oral Maxillofac Surg. 2017 Apr;118(2):109-114. doi: 10.1016/j.jormas.2017.02.005. Epub 2017 Feb 22.
Bradykinin-mediated angioedema (AE) is a rare disease characterized by recurrent cutaneous or mucosal angioedema. This hereditary or acquired disease is of rapid installation, non-pruritic, usually painless and can affect the face, lips, larynx, gastrointestinal tract or extremities. When the affected area involves the upper respiratory tract, laryngeal angioedema can lead to imminent death by asphyxia. This is the reason for the high mortality rate (30 %) in undiagnosed or improperly managed patients. High-risk situations in oral and maxillofacial surgery procedures should be identified preoperatively. Short-term prophylaxis must be carried-out prior to any procedure that may trigger an attack. A multi-site reference center (CREAK) has been created to help clinicians to manage this disease. This article reviews the pathophysiologic mechanisms, the clinical presentations, the possible treatments, the acute strategies for attacks and different prophylactic possibilities in oral and maxillofacial surgery.
缓激肽介导的血管性水肿（AE）是一种罕见疾病，其特征为复发性皮肤或黏膜血管性水肿。这种遗传性或获得性疾病起病迅速，无瘙痒感，通常无痛，可累及面部、唇部、喉部、胃肠道或四肢。当受累区域涉及上呼吸道时，喉血管性水肿可导致窒息猝死。这就是未确诊或处理不当的患者死亡率高（30%）的原因。口腔颌面外科手术中的高风险情况应在术前确定。在任何可能引发发作的手术前，必须进行短期预防。已设立了一个多地点参考中心（CREAK）以帮助临床医生管理这种疾病。本文综述了口腔颌面外科中该病的病理生理机制、临床表现、可能的治疗方法、发作的急性处理策略以及不同的预防方法。
