31例慢性硬化性颌下腺炎的临床病因及诊断分析

目的分析慢性硬化性颌下腺炎的临床资料,探讨其病因和诊断方法。方法回顾2005～2011年收治的31例慢性硬化性颌下腺炎的病例资料,分析其病因、病理、临床表现及辅助检查的特点。结果 31例慢性硬化性颌下腺炎中,单侧发病93.6%(29/31);慢性感染80.6%(25/31),感染伴涎石症64.5%(20/31),尚有19.4%(6/31)原因不明。病例中Ⅲ、Ⅳ期病理变化占93.5%(29/31)。临床表现主要为局部肿硬包块,伴饮食症状者占60%;术前高频彩超、细胞学穿刺均能反映腺体纤维化的特点,但不具有疾病确诊性。结论慢性硬化性颌下腺炎为多因素疾病,免疫因素在疾病发展中可能起着重要作用,本病诊断主要依赖于活组织病检。

Objective To analyze the clinical data of 31 cases of chronic sclerosing sialadenitis of submandibular gland so as to explore the causes and diagnosis for the clinical treatment services. Methods Through a review of cases, we analyze patient data, summarizing their etiology, pathology, clinical manifestations and laboratory examination characteristics. Results Unilateral disease account for 93.6%. Chronic infection has 80.6%. At the same time, the infection with salivary stone disease account for 64.5%. The remaining 19.4% is still unexplained. Cases of pathological stage III, IV accounted for 93.5%. The local swelling hard mass is main clinical feature. 60% have associated swelling when eating. Preoperative high-frequency ultrasound and puncture cytology can reflect the characteristics of the gland fibrosis, but not diagnosed with the disease. Conclusion Chronic sclerosing sialadenitis of the submandibular gland is multifactorial disease. Immune factors in the development of the disease may play an important role. The diagnosis depends on pathologic examination.