喉癌术后并发咽瘘的危险因素分析  

Analysis of Risk Factors of Pharyngeal Fistula after Laryngeal Cancer Surgery

作　　者：梁云 王晓明[1] 温丽慧[1] 梁恒伟 LIANG Yun;WANG Xiaoming;WEN Lihui;LIANG Hengwei(Department of Otolaryngology Head and Neck Surgery I,Qinzhou Second People's Hospital,Qinzhou,Guangxi Zhuang Autonomous Region,535000 China)

机构地区：[1]钦州市第二人民医院耳鼻咽喉头颈外科一区,广西钦州535000

出　　处：《系统医学》2024年第9期22-24,28,共4页Systems Medicine

基　　金：钦州市科学研究与技术开发自筹经费科研课题(20233121)。

摘　　要：目的探讨喉癌术后并发咽瘘的危险因素。方法回顾性选取2019年1月—2023年9月钦州市第二人民医院行喉癌手术的157例患者的临床资料。根据患者术后咽瘘分为咽瘘组(n=27)和非咽瘘组(n=130),采用多因素Logistic回归分析确定喉癌术后并发咽瘘的风险因素。结果病理分级>T3、肿瘤分期>Ⅲ期、术前血红蛋白(Hemoglobin,Hb)<118.5 g/L、术中出血量>184.5 mL、鼻胃管置留时长>15.5 d是喉癌患者术后并发咽瘘的独立风险因素(OR=2.271、4.109、0.929、1.026、1.573,P均<0.05)。结论患者的病理分级较高、肿瘤分期较高、术前Hb较低、术中出血量较高、鼻胃管置留时长较长会增加喉癌患者术后并发咽瘘的风险。Objective To investigate the risk factors of pharyngeal fistula after laryngeal cancer surgery.Methods The clinical data of 157 patients who underwent laryngeal cancer surgery in the Second People's Hospital of Qinzhou City from January 2019 to September 2023 were retrospectively selected.According to postoperative pharyngeal fistula,patients were divided into pharyngeal fistula group(n=27)and non-pharyngeal fistula group(n=130).Multivariate Logistic regression analysis was used to determine the risk factors of pharyngeal fistula after laryngeal cancer surgery.Results Pathological grading>T3,tumor staging>stage III,preoperative hemoglobin(Hb)<118.5 g/L,intraoperative bleeding>184.5 mL,and nasogastric tube retention time>15.5 d were independent risk factors for postoperative pharyngeal fistula in laryngeal cancer patients(OR=2.271,4.109,0.929,1.026,1.573,all P<0.05).Conclusion The higher pathologic grade,higher tumor stage,lower preoperative Hb,higher intraoperative blood loss and longer nasogastric tube retention time of patients with laryngeal cancer will increase the risk of postoperative pharyngeal fistula.

关 键 词：喉癌术后 咽瘘 危险因素 

分 类 号：R739[医药卫生—肿瘤]