Noma (cancrum oris): questions and answers.

Noma (cancrum oris): questions and answers.
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Noma(cancrum oris):问题与解答。

DOI:
10.1111/j.1601-0825.1999.tb00080.x
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发表时间:
1999
期刊:
Oral diseases.
影响因子:
--
通讯作者:
Savage,KO
Savage,KO
中科院分区:
--
文献类型:
--
作者:
Enwonwu,CO;FalklerJr,WA;Idigbe,EO;Savage,KO

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坏疽性口癌是一种传染性疾病,在其发作过程中破坏口腔-面部组织和其他邻近结构。它主要影响撒哈拉以南非洲地区2-16岁的儿童,在那里,一些社区的估计发病率可能从每1000名儿童1例到7例不等。主要风险因素是贫穷、营养不良、口腔卫生不良、环境卫生条件差、住所靠近牲畜以及传染病,特别是麻疹。营养不良与地方性感染协同作用,促进免疫缺陷状态,而坏疽性口炎是一般和局部因素相互作用的结果,其共同特征是免疫系统减弱。急性坏死性牙龈炎(ANG)被认为是先兆病变。目前的研究表明,ANG向坏疽性口炎的进化需要一组微生物的感染,其中坏死梭杆菌和中间普氏菌可能是关键的参与者。如果没有适当的治疗,死亡率为70-90%。幸存者遭受面部畸形和功能障碍的双重痛苦。对于贫穷的受害者来说,由此产生的畸形的重建手术既耗时又经济。
Noma (cancrum oris) is an infectious disease which destroys the oro‐facial tissues and other neighboring structures in its fulminating course. It affects predominantly children aged 2–16 years in sub‐Saharan Africa where the estimated frequency in some communities may vary from one to seven cases per 1000 children. The key risk factors are poverty, malnutrition, poor oral hygiene, deplorable environmental sanitation, close residential proximity to livestock, and infectious diseases, particularly measleS. Malnutrition acts synergistically with endemic infections in promoting an immuno‐deficient state, and noma results from the interaction of general and local factors with a weakened immune system as the common denominator. Acute necrotizing gingivitis (ANG) is considered the antecedent lesion. Current studies suggest that evolution of ANG to noma requires infection by a consortium of microorganisms withFusobacterium necrophorumandPrevotella intermediaas the suspected key playerS. Without appropriate treatment, mortality rate is 70–90%.Survivors suffer the twofold affliction of oro‐facial disfigurement and functional impairment. Reconstructive surgery of the resulting deformity is time‐consuming and financially prohibitive for the victims who are poor.
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