五、治疗
(一)一般治疗
1.首选手术切除,也可采用冷冻治疗或烧灼刮除。
2.全身放射治疗可使口腔结节消退,但不能防止结节再次出现,瘤体内放射治疗亦有效。亚砷酸钾溶液内服或二甲基砷酸钠皮下注射,偶可使症状消失,免疫抑制剂治疗如氮芥、环磷酰胺、氨甲蝶呤、长春新碱等;90Sc敷贴治疗亦有效。若因使用免疫抑制剂所致的Kaposi肉瘤,则应停止使用免疫抑制剂,而用胸腺肽或用白介素-2重建免疫功能。
(二)口腔颌面部异常相关的治疗建议
首选手术切除,也可采用冷冻治疗或烧灼刮除。
参考文献
[1]Wood L F,Chahroudi A,Chen H L,et al.The oral mucosa immune environment and oral transmission of HIV/SIV[J].Immunological Reviews,2013,254(1):34-53.
[2]Yarchoan R,Uldrick T S.HIV-associated cancers and related diseases[J].The New England Journal of Medicine,2018,378(11):1029-1041.
[3]Mariggiò G,Koch S,Schulz T F.Kaposi sarcoma herpesvirus pathogenesis[J].Philosophical Transactions of the Royal Society B:Biological Sciences,2017,372(1732):20160275.
[4]Ethel Cesarman,Blossom Damania,et al.Kaposi Sarcoma[J].Nat Rev Dis Primers,2019,31,5(1):9(https://www.daowen.com)
[5]Goncalves P H,Uldrick T S,Yarchoan R.HIV-associated kaposi sarcoma and related diseases[J].AIDS,2017,31(14):1903-1916.
[6]Schneider J W,Dittmer D P.Diagnosis and treatment of kaposi sarcoma[J].American Journal of Clinical Dermatology,2017,18(4):529-539.
[7]Giuseppe Mariggiò,Sandra Koch,Thomas F.Schulz.Kaposi sarcoma herpesvirus pathogenesis[J].Philos Trans R Soc Lond B Biol Sci,2017,10(19):372.
[8]Silva L,Azurara L,Monteiro A F,et al.Pediatric Kaposi's sarcoma associated with immune reconstitution inflammatory syndrome[J].Pediatr Dermatol.2020,37(1):239-240.
[9]Huang A Y,Lin C L,Chen G S,et al.Clinical features of Kaposi's sarcoma:experience from a Taiwanese medical center[J].Int J Dermator.2019,58(12):1388-1397.
[10]Komitova R,Chudomirova K,Abadjieva T.Pulmonary Kaposi's Sarcoma-Initial Presentation of HIV Infection[J].Folia Med.2019,61(4):643-649.
[11]付茜,肖江,周新刚,等.获得性免疫缺陷综合征相关型卡波西肉瘤口腔病损的临床特点[J].中华实验和临床感染病杂志(电子版),2017,11(4):359-363.
[12]张剑锋,李张维,李多.获得性免疫缺陷综合征患者的口腔表征及防治的研究进展[J].口腔医学,2010,30(12):753-754.
(蒋红柳 王文梅)