世界最新医学信息文摘（连续型电子期刊）
世界最新醫學信息文摘（連續型電子期刊）
세계최신의학신식문적（련속형전자기간）
World Latest Medicine Information
2015年
42期
20-21
,共2页
双膦酸盐%放疗%下颌骨坏死%临床药师
雙膦痠鹽%放療%下頜骨壞死%臨床藥師
쌍련산염%방료%하합골배사%림상약사
Bisphosphonates%Radiotherapy%Osteonecrosis of the jaw%Clinical pharmacist
目的：分析颌骨坏死的原因和双膦酸盐相关性颌骨坏死的机制。方法采用回顾性分析法对1例患者的病例资料进行分析，该患者为女性乳腺癌患者，因骨转移，给予唑来膦酸4 mg，溶于0.9%氯化钠注射液100 mL，静脉滴注，共22次，后给予伊班膦酸4 mg，溶于0.9%氯化钠注射液500 mL，静脉滴注，共7次。期间因颅脑转移行全脑放疗。本次入院后给予伊班膦酸治疗后患者自述口腔黏膜肿痛，口腔科诊断为颌骨坏死。考虑下颌骨坏死可能与双膦酸盐相关，或者与放疗和双膦酸盐两者相关。结果嘱患者行X线检查确认是否颌骨坏死，患者拒绝。但随着双膦酸盐的广泛应用，有关含氮双膦酸盐相关性骨坏死的报告也日渐增多，患者长期应用双膦酸盐抗骨转移治疗，不排除双膦酸盐所致下颌骨坏死。结论双膦酸盐相关的颌骨坏死是一个非常严重的副作用。在使用双膦酸盐治疗时，必须认真分析风险—效益的关系，事先向患者解释清楚，使患者有心理准备。如果患者需要进行双膦酸盐治疗，则应该给予其严格的口腔卫生措施，对其定期进行牙科检查，指导其合理、科学使用药物，以降低双膦酸盐的副作用。
目的：分析頜骨壞死的原因和雙膦痠鹽相關性頜骨壞死的機製。方法採用迴顧性分析法對1例患者的病例資料進行分析，該患者為女性乳腺癌患者，因骨轉移，給予唑來膦痠4 mg，溶于0.9%氯化鈉註射液100 mL，靜脈滴註，共22次，後給予伊班膦痠4 mg，溶于0.9%氯化鈉註射液500 mL，靜脈滴註，共7次。期間因顱腦轉移行全腦放療。本次入院後給予伊班膦痠治療後患者自述口腔黏膜腫痛，口腔科診斷為頜骨壞死。攷慮下頜骨壞死可能與雙膦痠鹽相關，或者與放療和雙膦痠鹽兩者相關。結果囑患者行X線檢查確認是否頜骨壞死，患者拒絕。但隨著雙膦痠鹽的廣汎應用，有關含氮雙膦痠鹽相關性骨壞死的報告也日漸增多，患者長期應用雙膦痠鹽抗骨轉移治療，不排除雙膦痠鹽所緻下頜骨壞死。結論雙膦痠鹽相關的頜骨壞死是一箇非常嚴重的副作用。在使用雙膦痠鹽治療時，必鬚認真分析風險—效益的關繫，事先嚮患者解釋清楚，使患者有心理準備。如果患者需要進行雙膦痠鹽治療，則應該給予其嚴格的口腔衛生措施，對其定期進行牙科檢查，指導其閤理、科學使用藥物，以降低雙膦痠鹽的副作用。
목적：분석합골배사적원인화쌍련산염상관성합골배사적궤제。방법채용회고성분석법대1례환자적병례자료진행분석，해환자위녀성유선암환자，인골전이，급여서래련산4 mg，용우0.9%록화납주사액100 mL，정맥적주，공22차，후급여이반련산4 mg，용우0.9%록화납주사액500 mL，정맥적주，공7차。기간인로뇌전이행전뇌방료。본차입원후급여이반련산치료후환자자술구강점막종통，구강과진단위합골배사。고필하합골배사가능여쌍련산염상관，혹자여방료화쌍련산염량자상관。결과촉환자행X선검사학인시부합골배사，환자거절。단수착쌍련산염적엄범응용，유관함담쌍련산염상관성골배사적보고야일점증다，환자장기응용쌍련산염항골전이치료，불배제쌍련산염소치하합골배사。결론쌍련산염상관적합골배사시일개비상엄중적부작용。재사용쌍련산염치료시，필수인진분석풍험—효익적관계，사선향환자해석청초，사환자유심리준비。여과환자수요진행쌍련산염치료，칙응해급여기엄격적구강위생조시，대기정기진행아과검사，지도기합리、과학사용약물，이강저쌍련산염적부작용。
Objective: To analyze the mechanism of osteonecrosis of the jaw and the causes of bisphosphonate associated osteonecrosis of the jaws.Methods:A retrospective analysis was made on the data of 1 patients.The patient was female breast cancer patients,received an IV infusion of zoledronie acid 4 mg dissolved in 0.9% sodium chloride 100 ml, 22 times.Then received an IV infusion of ibandronic acid 4 mg dissolved in 0.9% sodium chloride 500 ml,7 times.During this period, the patient received head radiotherapy for brain metastasis. During this period of the hospital,the Patient complain that their was a pain in the oral mucosa . Osteonecrosis of the jaw (ONJ) was diagnosed by dentists. ONJ was considered to be associated with pamidronate disodium, or both radiotherapy and bisphosphonates.Results:The patients were instructed by X-ray examination to confirm whether the osteonecrosis of the jaw, the patient refused. But with the wide application of bisphosphonates, containing nitrogen bisphosphonate associated osteonecrosis of the report is also increasing, patients with long-term use of bisphosphonates anti treatment of bone metastases, not to the exclusion of bisphosphonate induced osteonecrosis of the jaw.Conclusion:Bisphosphonate related osteonecrosis of the jaw is a very serious side effects.In the use of bisphosphonates, must carefully analyze the risk - benefit,explain to patients in advance, so that patients with psychological preparation.If patients need bisphosphonate therapy, should be given the strict oral hygiene measures,regular dental examination,guidance for patients with rational and scientific use of drugs,in order to reduce the side effects of bisphosphonates.
