口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (9): 577-583.DOI: 10.12016/j.issn.2096-1456.2021.09.001

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腮腺慢性阻塞性疾病的再认识

陶谦(),黄韵   

  1. 中山大学光华口腔医学院·附属口腔医院口腔颌面外科, 广东省口腔医学重点实验室, 广东 广州(510055)
  • 收稿日期:2020-11-27 出版日期:2021-09-20 发布日期:2021-06-18
  • 通讯作者: 陶谦
  • 基金资助:
    广东省科技计划项目(2017A020211025)

Re-cognition of chronic obstructive diseases of the parotid gland

TAO Qian(),HUANG Yun   

  1. Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2020-11-27 Online:2021-09-20 Published:2021-06-18
  • Contact: Qian TAO
  • Supported by:
    Science and Technology Project of Guangdong Province(2017A020211025)

摘要:

腮腺慢性阻塞性疾病(chronic obstructive diseases of parotid)在临床多见,病情反复,治疗效果欠佳。本文参阅“腮腺反复肿胀”相关文献,结合个人临床实践和研究成果,从病因学的角度将腮腺阻塞性疾病分为机械性阻塞、特异性阻塞和非特异性阻塞3大类,并引入流体力学的原理解释腮腺阻塞的机制,针对不同病因提出改变腮腺微流场中唾液流动状态,减少流动阻力以解除阻塞的治疗新思路:传统的结石取出可清除导管内机械性阻塞,药物促进唾液分泌以改变唾液粘滞度,内镜下扩张导管或放置支架以扩大管径,选择性栓塞侧支导管以减少流场中高压区和低速区等等,这些方法均能有效提高唾液流动速率,减少唾液滞留和腮腺阻塞的发生。

关键词: 腮腺阻塞, 结石病, 慢性复发性腮腺炎, 舍格伦综合征, IgG4相关性腮腺炎, 放射性腮腺炎, 非特异性腮腺炎, 流体力学, 治疗策略

Abstract:

Chronic obstructive diseases of the parotid gland are common clinically, with repeated swelling and a prolonged course and poor treatment outcomes. Based on the summarization of clinical practice and related literature, from the viewpoint of etiology, parotid obstructive diseases can be classified as mechanical obstructions, specific obstructions and non-specific obstructions. The principles of fluid mechanics are introduced to explain the formation of parotid obstructions. According to the different causes, the methods of changing the flow pattern of saliva in the parotid to reduce the resistance and relieve the obstruction, are proposed, such as mechanical factors removals, application of drugs that promote saliva secretion and lower saliva viscosity, ductal expansion under endoscopy and stent placement, and embolization of collateral ducts. These managements can effectively increase the salivary flow rate, reduce the occurrence of the saliva stranded and parotid gland obstructions.

Key words: obstruction of parotid gland, lithiasis, chronic recurrent parotitis, Sjögren’s syndrome, IgG4-related parotitis, radiation-induced parotitis, non-specific parotitis, fluid mechanics, therapeutic strategy

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