颌下腺移位术预防鼻咽癌放疗后口咽干燥症临床观察  

Clinical observation on the proventing effect of submandibular gland transposition against oralopharyngeal xerosis for cases with nasopharyngeal cancer recieving radiotherapy

作　　者：汪永干[1] 胡春玖[1] 史前妹[1] 林忠明[1] 汪延宏[1] 胡联国[1] 谢芳[1] 周具华[1] 蔡强[1] 

机构地区：[1]安徽省铜陵市人民医院耳鼻咽喉头颈外科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2009年第3期146-147,159,168,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的观察颌下腺移位术预防鼻咽癌放疗后口咽干燥症的临床效果。方法2006年9月-2008年10月连续诊治的20例鼻咽癌患者中，选择符合入选标准的8例患者（试验组），于放疗前将颌下腺移位至颏下区，术后接受常规放疗，放疗中颏下区设置挡块以保护移位之颌下腺；其余12例（对照组）接受常规放疗。系统观察比较放疗中的急性口腔黏膜反应，并于放疗后3个月进行口干程度调查。结果试验组病例中，4例患者疗后无口咽干燥症状，4例患者疗后有轻微口干感觉；对照组12例皆口干症状。试验组和对照组放疗后唾液分泌量平均值分别为1．3和0．68g，差异有统计学意义（P〈0．01）。结论颌下腺移位术预防鼻咽癌放疗后口咽干燥症的近期疗效好，有利于改善患者放疗后的生活质量。Objective To investigate the preventive effect of submandibular gland transposition against oropharyngeal xerosis for cases with nasopharyngeal cancer （NPC） receiving radiotherapy based on a clinical trial. Methods Included in this study were 20 cases with NPC treated in our Hospital from Sep. 2006 to Oct. 2008, with 8 cases consistent with the internalizing standards received the surgery with submandibnlar gland displaced into sub-mental region before radiotherapy as the experimental group （EG） and the other 12 received the routine therapy as the controlling group （CG）. Then, they were giving the routine radiotherapy, with the submental region protected by a lead backup to avoiding radiation damage from occurring on the dislocated submandibnlar gland during the therapeutic course, and the other 12 cases in CG were given the routine therapy in the same way as those of EG. All these patients in both groups were kept under close observation on their side effect manifestation of acute mucosal damage in oral cavity and pharynx during the radiation therapeutic course, and careful evaluation on the developing tendency of their oropharyngeal xerosis during the following 3 months after the radiotherapy. Results Among the cases of EG, 4 were seen with no dry mouth feeling and another 4 only with a slight feeling of dry mouth, while all those cases in CG were suffered form the symptom of dry mouth. Furthermore, the averaged amount of saliva secretion was 1.39 g for the cases of EG and it was 0.68 g for those in CG, with statistical significance for the difference between them （P 〈 0.01）. Conclusions Surgery of submandibular gland transposition holds significant effect on the prevention of oropharyngeal xerosis following radiotherapy for NPC cases, at least with significant therapeutic effect in short term on such a condition, and this Should be very helpful for them to improve their quality of life.

关 键 词：鼻咽癌 放疗副反应 口咽干燥症 颌下腺移位术 预防 

分 类 号：R739.63[医药卫生—肿瘤] R766[医药卫生—临床医学]