喉癌患者全喉切除术后咽瘘相关的多因素分析  

Analysis of multiple factors related to pharyngeal fistula after total laryngectomy in patients with laryngeal cancer

作　　者：邹平[1] 刘跃辉[1] 胡国文[1] ZOU Ping;LIU Yuehui;HU Guowen(Gaoming District People’s Hospital of Foshan,Foshan 528500,Guangdong,China)

机构地区：[1]佛山市高明区人民医院,广东佛山528500

出　　处：《新疆医学》2021年第9期1030-1032,共3页Xinjiang Medical Journal

摘　　要：目的分析喉癌患者全喉切除术后咽瘘发生的相关危险因素。方法研究对象为本院在2018年1月至2019年12月期间收治的250例行全喉切除术治疗的喉癌患者,对其临床资料进行回顾性分析,根据其术后有无发生咽瘘将其分为两组,一组为术后未发生咽瘘的患者,将其分为非咽瘘组(n=200),一组为术后发生咽瘘的患者,将其分为咽瘘组(n=50),对其影响术后咽瘘发生的危险因素进行多因素分析,同时对于有差异性的指标进行多元Logistic回归分析。结果250例喉癌患者中,共计50例患者术后发生咽瘘,咽瘘发生率为20.00%。将性别、年龄、肿瘤分期、术前放疗史、皮瓣修复、术后清蛋白、手术时间、颈淋巴结清扫以及拔除引流管时间纳入咽瘘发生单因素分析中,结果显示年龄、肿瘤分期、术前放疗、皮瓣修复以及手术时间和咽瘘发生相关(P<0.05)。将年龄、肿瘤分期、术前放疗、皮瓣修复以及手术时间这四个有统计学意义的单因素纳入多因素Logistic回归分析中,结果显示肿瘤分期、术前放疗、皮瓣修复以及手术时间和咽瘘的发生密切相关,是其独立危险影响因素(P<0.05)。结论对于采用全喉切除术治疗的喉癌患者,肿瘤分期、手术前有无放疗史、是否进行皮瓣修复以及手术时间长短是其术后咽瘘发生的高危影响因子,临床应该提高重视。Objective To analyze the risk factors of pharyngeal fistula after total laryngectomy in patients with laryngeal cancer.Methods The research objects were 250 patients with laryngeal cancer treated by total laryngectomy in our hospital from January 2018 to December 2019.Their clinical data wre retrospectively analyzed,According to whether pharyngeal fistula occurred after operation,they were divided into two groups.One group was patients who did not develop pharyngeal fistula after operation,and they were divided into non-pharyngeal fistula group(n=200),and the other group was patients who developed pharyngeal fistula after operation,which was divided into pharyngeal fistula group.Group(n=50),multivariate analysis was performed on the risk factors of postoperative pharyngeal fistula,and multiple logistic regression analysis was performed on the different indicators.Results Among 250 patients with laryngeal cancer,50 patients developed pharyngeal fistula after operation,and the incidence of pharyngeal fistula was 20.00%.Gender,age,tumor stage,preoperative radiotherapy history,skin flap repair,postoperative albumin,operation time,cervical lymph node dissection,and drainage tube removal time were included in the univariate analysis of pharyngeal fistula.The results showed age,tumor stage,surgery Pre-radiotherapy,flap repair and operation time were related to the occurrence of pharyngeal fistula(P<0.05).Four statistically significant single factors including age,tumor stage,preoperative radiotherapy,flap repair,and operation time were included in the multivariate logistic regression analysis.The results showed that tumor stage,preoperative radiotherapy,flap repair,and operation time,the occurrence of pharyngeal fistula is closely related and is its independent risk factor(P<0.05).Conclusion For patients with laryngeal cancer treated with total laryngectomy,tumor staging,pre-operation history of radiotherapy,whether to repair skin flaps,and the length of operation are high-risk factors for the occurrence of postoperativ

关 键 词：全喉切除术 喉癌 咽瘘 影响因素 

分 类 号：R762[医药卫生—耳鼻咽喉科]