多层螺旋 CT 对涎腺结石的诊断价值

目的:探讨多层螺旋CT(MDCT)对涎腺结石的诊断价值及MDCT表现,了解其影像特点。方法:对具有完整头颈部MDCT资料并经手术病理证实的31例涎腺结石的MDCT进行回顾性分析。结果:31例患者共计有阳性结石39个,下颌下腺结石30例(96.77%),7例患者(22.58%)具有多发结石,18例(58.06%)病例伴有明显的炎性症状,结石体积、结石的位置与下颌下腺炎性症状相关,结石越靠后、结石体积越大,下颌下腺炎性症状就越重。结论:MDCT对涎腺结石的诊断有重要的应用价值,能确定结石的形态、数目、大小并定位,为临床手术治疗提供依据。     

下颌下腺保存治疗新技术体系的建立与应用

The saliva secreted from submandibular gland (SMG) accounts for 60%-65%. It plays an important role in maintaining the human function of swallow, digestion, testing, speech, protection of oral mucosa, and prevention from dental carries. The SMG is frequently resected during the treatment for various kinds of oral and maxillofacial diseases, resulting in xerostomia and decreased quality of life. During the past 15 years, Research Center of Salivary Gland Diseases in Peking University School and Hospital of Stomatology conducted a series of studies on new techniques for preservation of SMG and achieved remarkable results. The clinicopathologic and imaging characteristics of IgG4-related sialadenitis (IgG4-RS) were clarified based on systematic studies. The results of studies on the pathogenesis of IgG4-RS showed that unbalance of inflammatory factors mediated the abnormality of secretion of SMG. IL-4 participates in occurring and development of glandular fibrosis of SMG. Regulation of tumor necrosis factor α (TNF-α) and cleaning of senescent cells might be taken as the targets for treatment of IgG4-RS. The combination of glucocorticoid and steroid-sparing agents showed effective results for treating IgG4-RS, clinical remission was achieved in all the patients, serum IgG4 levels decreased, and salivary gland secretion significantly increased. Sialoendoscopy-assisted sialolithectomy was applied in the treatment of about 1 000 cases with submandibular hilar calculi with a success rate of more than 90%. Transfer of SMG was used for prevention from radiation-induced xerostomia in the patients with head and neck carcinoma. SMG was transferred to the submental region before radiotherapy and was kept away from the ra-diation field. The results of prospective clinical controlled study showed this technique could effectively preserve the function of SMG and prevent from xerostomia. Based on the micro-anatomical study on the blood vessels and ducts of SMG, partial sialoadenectomy was applied for treatment of benign tumors in the SMG. A clinical controlled study confirmed its safety for control of the tumors and its advantage of preservation of SMG function. The studies on the involvement of SMG in oral squamous cell carcinoma (OSCC) provided the anatomical and histopathological basis for preservation of SMG during neck dissection for early cases with OSCC. A innovated surgical modality "four preservations including SMG" was used during the neck dissection for the early cases with OSCC. A prospective randomized clinical controlled study confirmed its safety, feasibility, effectiveness for control of the carcinoma, and advantages of preservation of SMG function.     

异丙肾上腺素腹腔注射后SD大鼠下颌下腺的组织学观察

目的 建立异丙肾上腺素（IPR）腹腔注射的SD大鼠模型,观察IPR腹腔注射后腺体的组织学变化。方法 12只SD大鼠随机分成IPR注射组和对照组。IPR注射组按20 mg/kg剂量腹腔内注射盐酸异丙肾上腺素,2次/d,连续注射5 d。对照组则以无菌生理盐水代替盐酸异丙肾上腺素。5 d后处死动物,取出腺体。通过HE及免疫组织化学染色观察其组织化学变化。结果 IPR注射5 d后,腺泡及腺泡细胞体积明显增大,大部分腺泡细胞及少量导管细胞胞Ki-67阳性表达。导管细胞及导管附近细胞胞浆内可见Amylase阳性的分泌颗粒。结论 闰管细胞中存在能够转化为腺泡细胞的成体干细胞。IPR注射能促使下颌下腺干/祖细胞开始表达这些潜在特性并分化为腺泡细胞。     

颌下腺内鱼刺1例报告

<正>临床工作中颌下腺内异物相对少见,目前文献报道有笤帚梢杆经口底黏膜进入颌下腺内1例,采取手术治疗[1];吞咽麦芒1月后颌下不适,超声检查发现麦芒异物1例,手术取出异物[2];也有报道颌下腺内铅笔芯1例,但因病史较长文献未能提供异物移行颌下腺内的可能途径。本文报道咽部鱼刺异物移行颌下腺1例。1临床资料患者,男,42岁,因"右侧颌下区反复肿痛1月"入院。查体:右侧颌下区肿胀,肿胀区压痛明显,皮     

颌下腺原发性鳞状细胞癌2例

颌下腺原发性鳞癌临床上少见,相关报道较少。我们于2008年、2012年各收治1例,结合患者临床资料和文献,回顾性分析其特点,报道如下。     

甘露聚糖肽致速发型过敏反应1例

病例：患者，女，18岁，49kg，因“无明显诱因出现左颌下肿痛5天，双耳下肿痛1天”于2008年3月17日入我院感染科治疗。既往无其他病史及药物过敏史。入院查体：体温36．2℃，呼吸20次／分，心率78次／分，血压117／70mmHg（1mmHg=0．133kPa）。神志清，精神可。双侧颌下腺肿大如杏核样，触痛，质略硬；双侧腮腺肿大如杏样，触痛，质韧。     

益气温补中药治疗颌下腺肿瘤临床分析

颌下腺腺样囊性癌是颌下腺恶性肿瘤中最常见的类型,术后易局部复发和远处转移.国内外文献报道例数不多.本例手术未能根治切除后予放射治疗,放疗后服用益气温阳中药连续5年,停药2年后发生两肺广泛转移,再予原中药治疗至今3年余,目前一般情况良好,CT显示两肺多发小结节一直稳定.本患者多年来服用同一张处方情况良好,故药物与剂量从未更改,这在中医治疗肿瘤中较少见,现总结如下.     

颌下腺结石临床病理分析

目的探讨颌下腺结石发生的临床和病理相关性及其发病机制。方法光镜下观察颌下腺腺体的病理变化，对颌下腺结石患者进行临床、X线片及病理资料复习，对其临床资料进行分析。结果证实颌下腺结石发生与性别、病程、细菌感染、口腔环境密切相关。结论注意保持口腔清洁卫生预防颌下腺结石的关键。     

颌下腺导管巨大结石自行排出1例

患者，女，18岁，学生。患者4年前偶尔感觉右颌下胀痛，进食时感觉明显，并能触到右颌下有一肿物，曾到当地卫生院诊断为右颌下淋巴结炎，给予抗炎治疗，数天后症状慢慢减轻，有时症状轻，不治也能自消。但4年来反复发作多次，症状逐次加重，每次均要注射抗生素，肿痛才能消除。此次于3天前又开始肿痛，右颌下肿物明显增大，在校卫生室按颌下淋巴结炎给予抗炎治疗，效果不明显并伴有低烧。于2006年7月15日来我院门诊，要求进一步检查治疗。