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体外冲击波碎石术治疗唾液腺结石:一项 55 例患者的研究。

Extracorporeal lithotripsy of salivary gland stone: A 55 patients study.

机构信息

Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France; Oral surgery department, odontology, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France.

Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Oral & maxillofacial department, Conception hospital, AP-HM, 147, boulevard Baille, 13005 Marseille cedex 5, France.

出版信息

J Stomatol Oral Maxillofac Surg. 2018 Nov;119(5):375-378. doi: 10.1016/j.jormas.2018.03.006. Epub 2018 Mar 21.

Abstract

Sialolithiasis are the most frequent salivary gland disease, mainly affecting the submandibular gland. With the advent of minimally invasive techniques, total salivary gland removal should not be considered as the first-line treatment anymore. Extracorporeal Shock Wave Lithotripsy (ESWL) is an alternative to surgery preserving the gland. The objective of our retrospective study was to evaluate the efficiency of ESWL on pain and obstructive syndrome in patients suffering from sialolithiasis. The global result felt by the patients was also considered. All patients treated between October 2009 and July 2016 for sialolithiasis by ESWL in our department were included. They were divided into two groups according to the concerned gland: a parotid gland (PG) and a submandibular gland (SMG) group. Our retrospective telephone questionnaire consisted in 4 questions about their symptomatology before and after ESWL, including pain self-evaluation before and after treatment. They were finally asked to evaluate the global result of the ESWL treatment: excellent, good, mean, or poor. In total, 55 patients were included in this study, 38 patients in PG group and 17 patients in SMG group. We observed a decrease of pain and obstructive syndrom after ESWL procedure in both groups. Better results were found on the obstructive syndrome in the PG group. Very few side-effects were reported by patients. Given that it has very few side effects, ESWL can easily be considered as first line treatment for sialolithiasis to avoid heavier treatments such as surgery. It should be the first-line treatment for symptomatic parotid sialolithiases. The treatment of symptomatic submandibular sialolithiases depends on the topography of the lithiasis.

摘要

涎石病是最常见的唾液腺疾病,主要影响下颌下腺。随着微创技术的出现,全唾液腺切除术不应再被视为一线治疗方法。体外冲击波碎石术(ESWL)是一种保留腺体的替代手术。我们回顾性研究的目的是评估 ESWL 治疗涎石病患者疼痛和阻塞综合征的效果。还考虑了患者整体感觉的效果。我们部门在 2009 年 10 月至 2016 年 7 月期间对所有因涎石病接受 ESWL 治疗的患者进行了回顾性电话问卷调查,包括治疗前后的自我疼痛评估。根据涉及的腺体,他们被分为两组:腮腺(PG)和下颌下腺(SMG)组。我们的回顾性电话问卷调查包括 4 个关于他们 ESWL 前后症状的问题,包括治疗前后的疼痛自我评估。最后,他们被要求对 ESWL 治疗的整体效果进行评估:优秀、良好、中等或差。本研究共纳入 55 例患者,PG 组 38 例,SMG 组 17 例。我们观察到两组患者在 ESWL 后疼痛和阻塞综合征均有减轻。PG 组在阻塞综合征方面的效果更好。患者报告的副作用很少。鉴于 ESWL 副作用非常少,很容易将其视为治疗涎石病的一线治疗方法,以避免手术等更重的治疗。它应该是治疗有症状的腮腺涎石病的一线治疗方法。有症状的下颌下腺涎石病的治疗取决于结石的位置。

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