^(99)Tc^mO_4^-显像评价唾液腺自体移植治疗角结膜干燥症疗效

Application of^(99)Tc^mO_4^- scintigraphy for evaluating the effectiveness of autotransplantation of SSG in the treatment of xerophthalmia

目的 探讨99TcmO-4 唾液腺显像在角结膜干燥症颌下腺自体移植术前患者选择和术后判断移植腺体的活力、分泌功能及导管通畅中的价值。方法 12例重症干燥角结膜炎患者 ,均行99TcmO-4唾液腺显像 ,其中 9例行单侧自体腺体移植手术 ,术后再行99TcmO-4 唾液腺显像 ,其中 5例于术后 1周、1、3和 6个月进行动态及静态显像 ,观察移植腺体的形态、摄取显像剂情况及排泄管通畅与否。结果 术前 3例患者颌下腺显像不良 ,未行手术。 9例自体颌下腺移植术患者中 6例移植腺体摄取显像剂正常。但在早期 (1～ 4周 )除个别患者外 ,眼内均未见明显放射性分布 ;3个月后 ,6例患者眼内均有放射性分布 ,移植腺体功能均正常。 3例患者术后无泪液排出 ,其中 2例99TcmO-4 唾液腺显像阴性 ,手术证实为腺体坏死 ,1例经超声检查证实腺体无血运。另 1例移植腺体显像正常 ,但排泄导管不通 ,经冲洗导管后 ,眼内显影亦正常。结论 99TcmO-4 唾液腺显像可评估颌下腺功能 。

Objective To evaluate the efficiency of autotransplantation of submandibular salivary gland (SSG) in the treatment of xerophthalmia with 99 Tc mO - 4 SSG scintigraphy. Methods This study included 12 patients with severe xerophthalmia, 9 of the 12 cases had unilateral autotransplantation. At one week, one month ,three months and six months after surgery 99 Tc mO - 4 salivary gland scintigraphy was performed including dynamic and static imaging. Results Salivary gland image was badly displayed in three cases preoperatively,so no operation was done in those 3 cases. Nine cases had unilateral autotransplantation of submandibular salivary gland. Out of 9 cases, 6 patients had normal postoperation gland images, the remaining 3 had poor gland images and the grafts were confirmed necrosed by pathological study. Conclusion 99 Tc mO - 4 salivary gland scintigraphy is a very important technique in evaluation of function of submandibular salivary gland before and after transplantation.