内容简介
T/CHSA 004-2019下颌骨放射性骨坏死临床诊疗专家共识
Expert consensus on clinical diagnosis and treatment of osteoradionecrosis of mandible
2019- 12- 31实施
2019- 12-31发布
目 次
前言 ............................................................................... 1
引言 ................................................................................ 1
1 范围 .............................................................................. 1
2 术语及定义 ........................................................................ 1
3 病因学与高危因素 .................................................................. 2
4 诊断和鉴别诊断 .................................................................... 2
4.1 临床表现 ...................................................................... 2
4.2 影像学表现 .................................................................... 2
4.2.1 X 线片..................................................................... 2
4.2.2 电子计算机断层扫描 ........................................................ 3
4.2.3 MRI ....................................................................... 3
4.3 组织病理学 .................................................................... 3
4.4 诊断标准 ...................................................................... 3
4.5 鉴别诊断 ...................................................................... 3
5 BS 分类及分期...................................................................... 3
6 治疗 .............................................................................. 4
6.1 治疗原则 ...................................................................... 4
6.2 下颌骨 ORN 保守治疗 ............................................................ 4
6.2.1 口腔护理及创口处理 ........................................................ 4
6.2.2 高压氧治疗 ................................................................ 4
6.2.3 中医中药治疗 .............................................................. 5
6.2.4 其他治疗 .................................................................. 5
6.3 手术治疗 ...................................................................... 5
6.3.1 病灶刮除术 ................................................................ 5
6.3.2 下颌骨边缘性切除术 ........................................................ 5
6.3.3 下颌骨节段性切除术 ........................................................ 5
6.3.4 下颌骨节段性切除术血管化组织瓣修复 ....................................... 5
6.3.5 下颌骨切除后重建修复的注意事项 ............................................ 5
6.4 全身支持治疗 .................................................................. 6
6.4.1 营养支持治疗 .............................................................. 6
6.4.2 疼痛治疗 .................................................................. 6
6.4.3 抗感染治疗 ................................................................ 6
6.5 下颌骨 ORN 诊疗流程 ............................................................ 6
7 疗效评价 .......................................................................... 7
8 下颌骨 ORN 的预防 .................................................................. 7
8.1 手术预防措施 .................................................................. 7
8.2 放疗前的准备措施 .............................................................. 8
8.3 放疗过程中的预防措施 .......................................................... 8
8.4 放疗后的预防措施 .............................................................. 8
8.5 放疗方法和技术的改进 .......................................................... 8
参考文献 ............................................................................. 9
前 言
本标准按照GB/T1.1-2009给出的规则起草。
本标准由中华口腔医学会口腔颌面外科专业委员会提出。
本标准由中华口腔医学会归口。