Lazarus D, Hudson D A
Department of Plastic and Reconstructive Surgery, Red Cross War Memorial Children's Hospital, Cape Town.
S Afr Med J. 1997 Oct;87(10):1379-82.
To determine the factors predisposing to cancrum oris and its frequency, clinical features, treatment and outcome. Cancrum oris is a gangrenous condition of the face usually occurring in poorly nourished children in a Third-World setting.
Retrospective review of clinical data on children with cancrum oris.
All children with cancrum oris seen over a 35-year period, from 1960 to 1995, at Red Cross War Memorial Children's Hospital (RXH) in Cape Town.
Twenty-six patients (16 female and 10 male) with cancrum oris. Their average age at presentation was 4 years and 4 months (range 1-15 years).
The peak incidence was between 1971 and 1975 (11 cases); subsequently only 1 new case was seen at RXH in every 5-year period. Most children were referred from rural areas. Associated conditions could only be determined in 11 of the 26 patients. In order of frequency, these were malnutrition, gastro-enteritis, measles and anaemia. Twenty-three of the 26 children had soft-tissue involvement affecting the lips, cheek, chin, nose or other structures. Eighteen had bony or cartilaginous involvement; the maxilla was affected in 15, the palate in 7, the vomer in 5, the mandible in 3 and the nasal septum in 7. Three children had bony involvement only, the soft tissues being spared. Operative records were available for 18 children. These 18 children had a total of 84 operations, with an average of 4.7 per child (range 0-12).
Cancrum oris is a devastating condition affecting malnourished children. Reconstruction is complex and demanding, involving both soft tissue (23 of 26 cases) and bone (18 of 26 cases). Most children require multiple procedures. Prevention is best effected by comprehensive primary health care.
确定导致坏疽性口炎的因素及其发生率、临床特征、治疗方法和治疗结果。坏疽性口炎是一种面部坏疽性疾病，通常发生在第三世界国家营养不良的儿童中。
对坏疽性口炎患儿的临床资料进行回顾性分析。
1960年至1995年期间，在开普敦的红十字战争纪念儿童医院（RXH）就诊的所有坏疽性口炎患儿。
26例坏疽性口炎患者（16例女性，10例男性）。他们就诊时的平均年龄为4岁4个月（范围为1至15岁）。
发病高峰在1971年至1975年之间（11例）；此后，RXH每5年仅出现1例新病例。大多数儿童来自农村地区。在26例患者中，只有11例能确定相关疾病。按出现频率排序，这些疾病依次为营养不良、肠胃炎、麻疹和贫血。26例儿童中有23例出现软组织受累，累及嘴唇、脸颊、下巴、鼻子或其他结构。18例出现骨骼或软骨受累；上颌骨受累15例，腭部受累7例，犁骨受累5例，下颌骨受累3例，鼻中隔受累7例。3例儿童仅骨骼受累，软组织未受累。有18例儿童有手术记录。这18例儿童共接受了84次手术，平均每人4.7次（范围为0至12次）。
坏疽性口炎是一种影响营养不良儿童的严重疾病。重建手术复杂且要求高，涉及软组织（26例中的23例）和骨骼（26例中的18例）。大多数儿童需要多次手术。通过全面的初级卫生保健可实现最佳预防效果。
