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人羊膜:改善药物相关性颌骨骨坏死(MRONJ)的治疗方法?一项病例对照研究。

Human amniotic membrane: an improvement in the treatment of Medication-related osteonecrosis of the jaw (MRONJ)? A case-control study.

机构信息

Unit of Oral and Maxillofacial Surgery, Ca Foncello Hospital, 31100, Treviso, Italy.

Treviso Tissue Bank Foundation, Via dell'Ospedale 3, 31100, Treviso, Italy.

出版信息

Cell Tissue Bank. 2022 Mar;23(1):129-141. doi: 10.1007/s10561-021-09922-y. Epub 2021 Apr 15.

Abstract

The aim of this article is to report the results obtained by the use of HAM in surgical wound healing and the reduction of relapse in patients affected by Medication-related osteonecrosis of the jaw (MRONJ).The study involved patients with the diagnosis of MRONJ, surgically treated between October 2016 and April 2019, in a case-control setting. Enrolled patients were randomly divided into 2 groups. One group will be treated with resective surgery and with the insertion of HAM patch (Group A), while the second group had been treated exclusively with resective surgery (Group B).The patients underwent MRONJ surgical treatment with the placement of amniotic membrane patches at the wound site. Data regarding the long-term complications/functions were evaluated at 3, 6, 12, and 24 months after surgery. Pain measurements were performed before the intervention (T0), 7(T1) and 30(T2) days after surgery. 49 patients were included in the study. 2 patients of GROUP A after 30 days since they were surgically treated showed persistent bone exposure. 5 patients of group B demonstrated a lack of healing of the surgical wound with the persistence of bone exposed to 30 days after surgery. Statistical analysis ruled out any difference in OUTCOME (relapse) between GROUP A and B (p = 0.23). However, the Fisher test highlighted a significant difference between the use of HAM and only surgical treatment in pain at rest (p = 0.032). The use of amniotic membrane implement the patient's quality of life and reduce pain perception. has a learning curve that is fast enough to justify its routine use.

摘要

本文旨在报告使用 HAM 促进外科伤口愈合和减少药物相关性颌骨坏死(MRONJ)患者复发的结果。研究对象为 2016 年 10 月至 2019 年 4 月间接受手术治疗的 MRONJ 患者,采用病例对照研究设计。纳入的患者被随机分为两组。一组将接受切除术和 HAM 补丁插入治疗(A 组),另一组仅接受切除术治疗(B 组)。患者在伤口部位放置羊膜贴片,接受 MRONJ 手术治疗。在手术后 3、6、12 和 24 个月,评估长期并发症/功能的数据。在手术前(T0)、术后第 7 天(T1)和第 30 天(T2)进行疼痛测量。本研究共纳入 49 例患者。A 组中有 2 例患者在手术后 30 天仍存在持续性骨暴露。B 组中有 5 例患者手术伤口未愈合,术后 30 天仍存在骨暴露。统计分析排除了 A 组和 B 组在 OUTCOME(复发)方面的任何差异(p=0.23)。然而,Fisher 检验显示,在静息疼痛方面,HAM 的使用与单纯手术治疗之间存在显著差异(p=0.032)。羊膜的使用提高了患者的生活质量,减轻了疼痛感知。它具有足够快的学习曲线,足以证明其常规使用的合理性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2318/8854299/804cecfb92ea/10561_2021_9922_Fig1_HTML.jpg

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