口腔癌复发的临床危险因素

口腔癌的治疗近年来虽然取得了很大的发展，但其复发率仍较高，目前国内外对复发癌的再治疗越来越重视。本文从宿主全身因素，肿瘤本身因素和原发瘤治疗措施三个方面阐述临床因素对口腔癌复发的预后价值。     

口腔癌相关危险因素的流行病学调查分析

目的:进行口腔癌相关危险因素的流行病学调查,为口腔癌的预防提供依据。方法:采用流行病学问卷调查方法,在国内8个城市进行多中心大样本病例-对照研究。调查内容主要包括个人基本情况、全身疾病和口腔疾病史、口腔卫生习惯、吸烟与被动吸烟、饮用水及常用的饮料情况、运动及劳动情况、家族史等7个方面。采用SAS 8.2软件包对数据进行t检验或χ2检验,采用Logistic回归分析各因素与罹患口腔癌的关系。结果:经常参加运动、饮用牛奶、饮用水处理、高血压、口腔白斑、不良修复体、吸烟史、戒烟史、吸有过滤嘴烟等在病例组和对照组之间有显著差异(P<0.05)。吸烟时间越长、吸烟量越大,危险度越高(OR分别为3.57、4.78)。运动、饮用牛奶及饮用水处理可降低口腔癌的危险(OR分别为0.48,0.48和0.53)。结论:吸烟是口腔癌发生的重要因素,吸过滤嘴烟不能降低口腔癌的发生;运动、饮用牛奶及饮用水处理可降低口腔癌的发生。     

口腔癌患者术后吞咽障碍危险因素的系统评价

通过系统评价的方法探究口腔癌患者术后吞咽障碍的危险因素。     

口腔癌复发的临床危险因素

口腔癌的治疗近年来虽然取得了很大的发展,但其复发率仍较高,目前国内外对复发癌的再治疗越来越重视。本文从宿主全身因素,肿瘤本身因素和原发瘤治疗措施三个方面阐述临床因素对口腔癌复发的预后价值。     

口腔癌的预防

口腔癌是头颈部较常见的恶性肿瘤之一,其发生与多种内、外因素有关,包括吸烟、饮酒、病毒感染、营养不良、饮食习惯和局部刺激等,其中尤以吸烟、饮酒的危险性最大。尽管采用手术、放疗、化疗、生物治疗等治疗口腔癌取得了长足进展,但口腔癌的5年生存率仍然徘徊在64%左右,晚期患者的预后更差。因此,要提高口腔癌患者的生存率和生存质量,必须坚定不移地贯彻执行＂预防为主＂的卫生工作方针,力争做到早期发现、早期诊断和早期治疗。作者就目前口腔癌三级预防的相关问题进行了讨论。     

4 口腔癌放疗是第二原发癌发病的危险因素

因放射线可导致DNA损伤，因此射线照射可能是上呼吸-消化道癌变的潜在因素。部分学者认为．头颈癌放疗亦可能是第二原发癌发病的危险因素，但仍有学者对这一结论持怀疑态度。为此，作者对1973-1999年问在其癌症研究中心接受治疗的30221例患者进行回顾性研究，其中6163例(20．4％)先后出现第二原发癌。接受放疗或术后辅助放疗的患者第二原发癌的发病危险大大增加；而仅行手术的患者，     

口腔癌患者术前营养风险指数与术后疼痛的相关性分析

目的:分析口腔癌患者术前营养状态与术后镇痛药需求之间的关系。方法:回顾性纳入行口腔癌根治术的593例患者。收集人口学特征、合并症、术前检验结果、手术特点、术中药物的使用以及术后镇痛药的使用等资料。以营养风险指数(nutritional risk index, NRI)来评估患者术前的营养状态。使用Logistic回归对术前NRI与术后镇痛药需求的关系进行分析。结果:纳入患者术前NRI的中位值为94.6,355例患者(59.9%)术前有中重度营养不良风险(NRI≤97.5)。进行多因素Logistic回归分析,分别调整不同的混杂因素来分析口腔癌患者术前NRI与术后镇痛药需求的关系。当NRI以连续变量纳入分析时,患者术后镇痛药需求随NRI的升高而降低(P<0.05);当NRI以分类变量纳入分析时,NRI≤97.5的患者术后镇痛药需求较NRI>97.5的患者高(P<0.05)。结论:术前营养不良在口腔癌患者中比较常见,是患者术后镇痛药需求增加的危险因素。     

口腔癌患者就医延迟现状及其影响因素分析

目的: 探讨口腔癌患者就医延迟现状及其主要影响因素。方法: 采用口腔癌患者一般资料调查表、汉密尔顿焦虑及抑郁量表、就医情况问卷和家庭支持量表对72例口腔癌患者进行调查。结果: 口腔癌患者就医延迟发生率为48.5％;时间最短2 d,最长5年余,中位时间为120 d;就医延迟患者在居住状况、自觉疾病严重程度、焦虑及家庭支持与未延迟患者比较,其差异有统计学意义。结论: 口腔癌患者就医延迟现象较为普遍,且居住状况、自觉疾病严重程度、焦虑及家庭支持均为影响口腔癌患者就医延迟的主要因素。     

检测口腔癌的新技术

视觉增强病变观测仪（VELscope）是对患者进行评价的重要仪器，如果将患者的年龄及其他危险因素，如吸烟、饮酒和免疫状态等考虑在内，此仪器能够提高临床医师对患者口腔改变的判断力．包括癌前病变和细胞的恶性转化；对感染性疾病的检测可能产生假阳性结果，仅依赖此仪器也不能检测发育异常，但应用VELscope能够使医师判断病变的性质。并决定对病变进行活检的范围及最佳活检区域。     

口腔鳞状细胞癌临床流行病学研究现状

口腔、咽癌（简称口腔癌，OPC）是头颈部常见的恶性肿瘤，约占全身恶性肿瘤的3％。OPC的发病率在世界范围内呈上升趋势，尤其是在年轻女性，估计全球每年新发病例27．4万例。虽然癌症治疗已经取得了许多重要进展．但20世纪60年代至今，口腔癌的死亡率基本保持不变，5年生存率徘徊在50％左右。口腔癌的危险因素多种多样，包括化学致癌物、物理致癌因素、生物致癌因素、遗传、机体易感性和种族等等。了解口腔癌的流行病学和危险因素，有助于鉴别和治疗口腔癌高危患者，并针对口腔癌的发病因素，寻找积极有效的预防措施，最大限度地降低口腔癌的发病率和死亡率。     

Multivariate analysis of risk factors for postoperative wound infection following oral and oropharyngeal cancer surgery

Purpose

The goal of this study was to identify risk factors for wound infections in patients with oral cancer who underwent surgical procedures.

Oral Cancer: Risk Factors and Molecular Pathogenesis

Introduction  

Oral cancer is one of the most common cancers and it constitutes a major health problem particularly in developing countries. It is one of the leading causes of death. Tobacco and alcohol consumption appears to be the major determinants of oral cancer.     

638例舌鳞癌预后及影响因素分析

目的:研究舌鳞癌患者人口学及临床病理特征对总生存率的影响,筛选可能的预后影响因素.方法:选择2003—2013年间在上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科经病理确诊为舌鳞癌、户籍所在地为上海的住院患者.从住院病史中提取年龄、性别等人口学特征,病变部位、TNM分期、临床分期、组织学分级等临床病理特征数据....     

Risk factors for post-extraction bleeding in patients with haemophilia: a retrospective cohort study

Many guidelines and studies describe haemostatic management protocols for patients with haemophilia, but few have evaluated the risk factors for post-extraction bleeding. This retrospective cohort study was performed to investigate these risks among this group of patients. We used medical records to identify patients with haemophilia who underwent tooth extraction(s) between April 2006 and April 2019 in the Department of Oral and Maxillofacial Surgery at Nara Medical University Hospital, Nara, Japan, and conducted logistic regression analyses to identify risk or protective factors for post-extraction bleeding in procedures involving factor replacement therapy. Post-extraction bleeding was defined as bleeding that could not be stopped by biting down on gauze, and that required medical treatment between 30 min and 14 days after the extraction. A total of 151 extractions (84 interventions) in 55 patients fulfilled the inclusion criteria (130 extractions (72 interventions) in 48 patients with haemophilia A, and 21 extractions (12 interventions) in seven patients with haemophilia B). Post-extraction bleeding was observed in nine patients (16.3%), 10 interventions (11.9%), and 12 extractions (7.9%). On average, it occurred six days after the intervention, and on the fifth postoperative day after extractions. Use of mouth splints significantly reduced the risk (odds ratio: 0.13; p = 0.01) in patients on factor replacement therapy. We will conduct a prospective study to investigate the optimal type of splint and optimal splint-wearing period.     

Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

Background

Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries.

Objective

The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil.

Material and Methods

A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. Results: The main causes of trauma were traffic accidents (45.7%) and physical assaults (24.3%), and differences in etiological factors were identified according to gender (p<0.001). The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01), physical assaults (p<0.001), falls (p<0.001) and sport injuries (p<0.01). In the multinomial logistic regression analysis (R² = 0.233; p<0.05), age was associated with injury in traffic accidents and falls (p<0.01), sports-related accidents were associated with males (p<0.05), and alcohol consumption with assaults and traffic accidents (p<0.001). Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%.

Conclusions

The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.     

Failure of oral implants: aetiology, symptoms and influencing factors

The use of oral implants opened a wide range of prosthetic treatment possibilities in edentulous patients. Although the reported success rates of oral implants are high, failures do occur. This paper reviews the current knowledge about the aetiology, the signs and symptoms and the possible influencing factors of implant failure. Possible causes of implant failure are thought to be infection of the periimplant tissues, occlusal overload, or a combination of both. Nevertheless, pinpointing one of these as the aetiological factor in a particular case is difficult and should be handled reluctantly. Although the cause might seem obvious, influencing factors could play a role as well. Gaining insight into these processes might stimulate the adoption of preventive action and therefore increase the predictability of the treatment outcome with oral implants. Received: 4 April 1997 / Accepted: 27 November 1997