@article{oai:niigata-u.repo.nii.ac.jp:00002977, author = {富沢, 美惠子 and 三富, 智恵 and 松山, 順子}, issue = {5}, journal = {小児歯科学雑誌, 小児歯科学雑誌}, month = {Dec}, note = {悪性腫瘍に罹患した小児の口腔病変の発現状態とその経過を明らかにする目的で,新潟県立ガンセンター新潟病院小児科に入院中の悪性腫瘍に罹患した小児54名について,定期的に口腔診査を行った。また,化学療法などの治療による全身状態の悪化に伴って発症しやすい口腔カンジダ症の予知のためカンジダ検査を行い,以下の結果を得た。1.症例は,男児33名,女児21名で,年齢は,生後6か月から15歳1か月に分布していた。2.診断の内訳は,急性リンパ性白血病22例,急性骨髄性白血病12例,悪性リンパ腫7例,神経芽腫4例,その他9例であった。3.口腔病変は54名中32名(59%)に観察され,歯肉の発赤・腫脹13例,口内炎10例,毛舌7例,口腔カンジダ症4例,出血斑3例,びらん・潰瘍2例,移植片対宿主病2例,アフタ1例であった。口内炎は,化学療法終了後5-7日目に多く発現していた。4.カンジダは,54例中9例(17%)で検出された。4例は口腔カンジダ症を発症しており,うち2例は,連続して頻回に検出されたことから,定期的なカンジダ検査と口腔診査の有効性が示された。9例中6例は要治療齲蝕歯を有していた。5.小児悪性腫瘍は一旦治療が開始されると歯科治療が困難になるため,治療開始前の歯科診査と治療開始後の定期的な口腔ケアが重要である。, Oral manifestations such as stomatitis, gingival hyperplasia, local hemorrhage and ulceration are seen as onset symptoms or during treatment in children with malignant tumors. Such oral lesions disturb swallowing and eating and seriously affect general health. It is, therefore, very important to prevent oral lesions in pediatric patients. For this purpose, we performed oral examinations and microbiological examination of Candida species at the pediatric clinic of Niigata Cancer Center Hospital between June 2003 and September 2004. Materials and Methods: Fifty-four patients (22 with acute lymphoblastic leukemia, 12 with acute myeloblastic leukemia, 7 with malignant lymphoma, 4 with neuroblastoma and 9 with other malignant tumors) were examined. The patients consisted of 33 males and 21 females. Their ages ranged from 6 months to 15 years 1 month. All of the patients were undergoing remission induction therapy, consolidation therapy, maintenance therapy or radiation therapy and all were given antifungal therapy orally (Amphotericin B syrup) and povidine iodine solution as a mouthrinse. Oral examination was carried out 1-11 times per child (av. 5.6 times) at the bedside using a dental miller and explorer under a small light every 2 or 3 weeks. Coating samples taken from the dorsal surfaces of the tongues were cultured on CHROMagar Candida plate medium. After incubation, Candida colonization was confirmed. Results and conclusion: Oral lesions were present in 32 patients (59%). These consisted of gingival swelling and redness in 13 patients, stomatitis in 10 patients, hairy tongue in 7 patients, oral cadidiasis in 4 patients, petechia in 3 patients, erosion or ulcer in 2 patients, graft versus host disease in 2 patients and aphtha in 1 patient. Stomatitis appeared after 5 or 7 days due to the chemotherapy. Candida was positive in 9 patients (17%) and 4 were diagnosed with oral candidiasis. Candida was positive several times in two of four patients with oral candidiasis. A periodical Candida screening test and oral examination are therefore important. Six of nine patients had untreated caries teeth. After beginning of the cancer therapy, dental treatment is very difficult for them. Dental examination prior to cancer therapy and dental care during treatment are very important.}, pages = {668--674}, title = {悪性腫瘍患児における口腔病変とカンジダの検出について}, volume = {42}, year = {2004} }