颌面部44例非霍奇金淋巴瘤的临床分析.DOCVIP

临床医学论文-颌面部44例非霍奇金淋巴瘤的临床分析 ?????????? 作者：李铮　沈志浩 尹明平 费伟??? 【关键词】? 颌面部 　　［摘要］? 目的：探讨颌面部ML的诊断方法和治疗措施。方法：对44例患者的临床资料进行回顾性分析。结果：44例中男性的发病明显多于女性，发病率随年龄增长而递增。B-NHL的发病明显多于T-NHL，B-NHL中高恶性占58%，低恶性占42%，而T-NHL全部为高恶性。舌根部及咽淋巴环的病变以中高恶性为多。治疗方法采用以COP和CHOP化疗方案为主的，包括手术、放疗和免疫治疗的综合性治疗方法。近期缓解率依其分期的和化疗疗程多少而不同，CR占36.3%，PR占59.0%，其中以手术切除+化疗的效果最好。结论：对于颌面颈部的肿块和溃疡不能以炎症解释，抗结核无效，应及时活检，并注意切取标本的方法。以COP和CHOP化疗为主的综合性治疗是最有效的治疗方法。 　　［关键词］? 颌面部? 淋巴瘤? 诊断? 治疗 　　A Clinical Analysis of Non-Hodgkin Lymphoma of 44 Cases in the Maxillofacial Region. 　　［Abstract］Objective: To study the diagnosis and treatment of malignant lymphoma in the maxillofacial region. Methods: Clinical information of 44 cases was analyzed and studied. Results: In the 44 cases, male was more than female. The incidence increased with the patients age. The percentage of B-NHL was higher than T-NHL. The percentage of middle and high level malignant grade B- NHL was 58%, and that of low level malignant grade B- NHL was 42%. All of T-NHL were high level malignant grade. The ML of Woldeyers ring was almost all high level malignant grade. The therapies were main COP and CHOP of the chemotherapy, including surgery, radiotherapy, and immunotherapy. The recent catabatic rate was different with the stages of the patients and length of chemotherapy period. CR was 25%, PR was 68%. Surgery combined with chemotherapy was the best therapy. Conclusions: If any mass and ulcer in the maxillofacial region can not be explained by inflammation and TB, biopsy is necessary. When biopsy is done, we must pay attention to excise sufficient tissues. The most efficiency therapy is COP and CHOP of the chemotherapy in combination with surgery and radiotherapy. 　　［Key words］? Maxillofacial region? Lymphoma? Diagnosis? Therapies ??? 恶性淋巴瘤（ML）是一组起源于淋巴组织的恶性肿瘤,可以发生于淋巴结或结外的淋巴组织,即可以发生于全身任何部位,颌面颈部也是好发部位之一。近些年来该病的发病率呈逐渐上升趋势。本文将以颌面外科为首诊的44例病例分析报道如下。 　　1? 材料与方法 　　1.1? 纳入标准? 收集选择1996年7月至2003年2月，在我科首诊的病人，经病理学检查确诊为恶性淋巴瘤44例，进行回顾性分析。 　　1.2? 临床资料? 患者44人，其中男34例，女10例。年龄7~82岁,平均年龄50岁，≥