唾液腺疾病:快速证据回顾。

IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
American family physician Pub Date : 2024-06-01
Michael J Kim, Anna Milliren, Dennis J Gerold
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引用次数: 0

摘要

主要的唾液腺是成对的腮腺、颌下腺和舌下腺。唾液腺疾病可影响腺体组织或其排泄系统。腮腺是最大的腺体,分泌的水样浆液性分泌物免疫原性较低。它们更容易受到感染和肿瘤的影响。颌下腺通过逆重力流动的颌下腺长导管产生含钙和磷酸盐较多的粘液性分泌物。80% 以上的唾液结石都是颌下腺造成的。颌下腺炎可以是急性或慢性的,由细菌、病毒和阻塞性病因引起;最常见的细菌是金黄色葡萄球菌。儿童最常见的病毒性病因是流行性腮腺炎(全球)和幼年复发性腮腺炎(接种疫苗的人群)。唾液腺肿大是由于全身性疾病引起的无症状慢性唾液腺肿大。唾液腺增生症的发病率高达 50%。它与脱水、营养不良、药物或慢性疾病引起的唾液淤积和炎症有关。外伤、狭窄和粘液瘤也会造成阻塞。肿瘤很少见,通常是良性的,但需要转诊并进行超声波、计算机断层扫描或磁共振咽喉造影检查。大多数疾病都可以通过保守治疗来控制,包括治疗潜在病因、优化易感因素、控制疼痛,以及通过唾液凝集剂、补水、按摩、热敷、口腔卫生和药物调整来增加唾液流量。唾液内窥镜检查是一种可治疗阻塞性和非阻塞性疾病的腺体保留技术。(Am Fam Physician.2024;109(6):550-559.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Salivary Gland Disorders: Rapid Evidence Review.

The major salivary glands are the paired parotid, submandibular, and sublingual glands. Salivary gland disorders can affect the glandular tissue or its excretory system. The parotid glands are the largest and produce aqueous serous secretions that are less immunogenic. They are more susceptible to infections and neoplasms. The submandibular glands produce mucinous secretions that are high in calcium and phosphate salts through a long submandibular duct that flows against gravity. The submandibular glands are responsible for more than 80% of salivary stones. Sialadenitis can be acute or chronic and caused by bacterial, viral, and obstructive etiologies; the most common bacteria is Staphylococcus aureus. The most common viral etiologies in children are mumps (globally) and juvenile recurrent parotitis (in vaccinated populations). Sialadenosis is a chronic asymptomatic enlargement of the salivary glands due to systemic disease. Sialolithiasis causes up to 50% of salivary gland disorders. It is associated with salivary stasis and inflammation caused by dehydration, malnutrition, medications, or chronic illness. Obstruction is also caused by trauma, stenosis, and mucoceles. Neoplasms are rare and typically benign, but they warrant referral and imaging with ultrasonography, computed tomography, or magnetic resonance sialography. Most disorders are managed with conservative measures by treating the underlying etiology, optimizing predisposing factors, controlling pain, and increasing salivary flow with sialagogues, hydration, massage, warm compresses, oral hygiene, and medication adjustment. Sialendoscopy is a gland-sparing technique that can treat obstructive and nonobstructive disorders. (Am Fam Physician. 2024;109(6):550-559.

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来源期刊
American family physician
American family physician 医学-医学:内科
CiteScore
2.80
自引率
2.50%
发文量
368
审稿时长
4-8 weeks
期刊介绍: American Family Physician is a semimonthly, editorially independent, peer-reviewed journal of the American Academy of Family Physicians. AFP’s chief objective is to provide high-quality continuing medical education for more than 190,000 family physicians and other primary care clinicians. The editors prefer original articles from experienced clinicians who write succinct, evidence-based, authoritative clinical reviews that will assist family physicians in patient care. AFP considers only manuscripts that are original, have not been published previously, and are not under consideration for publication elsewhere. Articles that demonstrate a family medicine perspective on and approach to a common clinical condition are particularly desirable.
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