基于倾向性评分匹配法评估喉癌术前营养不良对术后咽瘘及预后的影响  

Evaluation of the effect of preoperative malnutrition on postoperative pharyngeal fistula and prognosis of laryngeal cancer based on propensity score matching method

作　　者：黄丽敏 徐婧 柯清仙 林振孟 HUANG Limin;XU Jing;KE Qingxian;LIN Zhenmeng(Department of Head and Neck Tumor Surgery,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fujian,Fuzhou 350014,China)

机构地区：[1]福建医科大学肿瘤临床医学院,福建省肿瘤医院头颈肿瘤外科,福建福州350014

出　　处：《中国医药科学》2024年第14期13-16,62,共5页China Medicine And Pharmacy

基　　金：福建医科大学启航基金项目(2022QH1158)。

摘　　要：目的探讨术前营养不良对喉癌术后咽瘘及远期预后的影响。方法选取2015年5月至2019年9月福建省肿瘤医院收治的289例喉癌患者,分为营养良好组(n=196)和营养不良组(n=93)。采用倾向性评分匹配法比较术后咽瘘、住院时间以及3年生存率。结果多因素分析结果显示,年龄、术前营养不良、术前放疗、手术方式是术后咽瘘的独立危险因素(P<0.05)。成功匹配85对患者,与营养良好组相比,营养不良组的咽瘘发生率更高,住院时间更长,3年生存率更低(P<0.05)。结论喉癌术前营养不良不仅增加术后咽瘘的发生,延迟术后康复,而且对远期预后产生不利影响。Objective To investigate the effect of preoperative malnutrition on postoperative pharyngeal fistula and long-term prognosis of laryngeal cancer.Methods A total of 289 patients with laryngeal cancer in the Fujian Cancer Hospital from May 2015 to September 2019 were selected and divided into two groups:the non-malnutrition group(n=196)and the malnutrition group(n=93).The propensity score matching method was adopted to compare the postoperative pharyngeal fistula,length of stay and three-year survival rate of the two groups.Results Multivariate analysis showed that age,preoperative malnutrition,preoperative radiotherapy and surgical method were independent risk factors for postoperative pharyngeal fistula(P<0.05).85 pairs of patients were successfully matched.Compared with the non-malnutrition group,the malnourished group had higher incidence of pharyngeal fistula,longer length of stay and lower three-year survival rate(P<0.05).Conclusion Preoperative malnutrition of laryngeal cancer patients not only increases the incidence of postoperative pharyngeal fistula and delays postoperative rehabilitation,but also adversely affects the long-term prognosis.

关 键 词：喉癌 营养不良 咽瘘 预后 

分 类 号：R739.65[医药卫生—肿瘤]