颌骨放射性骨坏死治疗方法的选择。系统评价。
Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review.
机构信息
Entrerríos s/n, Santiago de Compostela C.P. 15782, Spain +
出版信息
Med Oral Patol Oral Cir Bucal. 2021 Mar 1;26(2):e195-e207. doi: 10.4317/medoral.24132.
BACKGROUND
to systematically review the literature, comparing the healing of osteoradionecrosis (ORN) among the therapeutic alternatives: surgical, pharmacological and combined.
MATERIAL AND METHODS
The review was organized according to the PRISMA protocol with regards to the following PICO question: patients with ORN of the jaws (P=Patient); all interventions reported (I = intervention); between all therapies (C=Comparison); healing of lesions (O=outcome).
RESULTS
Surgical treatment was the most common choice (46.3%) followed by pharmacological treatment, exclusively (25.9%) or combined (26.9%). Treatment exclusively by surgical intervention seems to be most effective option, with 51.2% of the lesions healed, OR for healing of 5.7 (CI95% 1.9-16.9, p=0.002). Only 1 case (0.9%) corresponded to low level laser therapy.
CONCLUSIONS
It seems clear that early intervention with conservative surgical combined with pharmacological methods improves the prognosis of ORN.
背景
系统回顾文献，比较治疗选择（手术、药物和联合）对放射性骨坏死（ORN）愈合的影响。
材料和方法
本综述按照 PRISMA 方案组织，针对以下 PICO 问题：颌骨 ORN 患者（P=患者）；所有报告的干预措施（I=干预）；所有治疗方法之间（C=比较）；病变愈合（O=结局）。
结果
手术治疗是最常见的选择（46.3%），其次是药物治疗（单独使用 25.9%，联合使用 26.9%）。单独手术干预似乎是最有效的选择，51.2%的病变愈合，OR 为 5.7（95%CI 1.9-16.9，p=0.002）。只有 1 例（0.9%）为低水平激光治疗。
结论
早期采用保守性手术联合药物治疗似乎可以改善 ORN 的预后。
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