全喉切除术后咽瘘相关因素分析

Study of pharyngo-cutaneous fistula after total laryngectomy

目的分析全喉切除术后咽瘘发生的相关因素。方法回顾分析我院2001年1月~2010年1月住院期间行全喉切除术后患者的临床资料,应用SPSS13.0进行统计学分析。结果 165例患者中26例发生术后咽瘘（15.76%）,其发生与肿瘤的临床分期分型、术前放疗、手术时间、颈部淋巴结清扫、是否合并糖尿病以及营养不良、鼻饲时间、术后感染有关（P〈0.01）。结论喉癌的早期诊断、治疗对于预防术后咽瘘的发生有重要作用,重视咽瘘发生的相关因素,制定合理的治疗措施,有助于预防咽瘘的发生。

Objective To explore the factors which lead to pharyngo-cutaneous fistula after total laryngectomy.Methods 165 hospitalized patients who underwent surgical treatment from Jan 2000 to Jan 2010 were restrospectively studied,applicate SPSS13.0 for statistical analysis.Results The rate of post-laryngectomy pharyngo-cutaneous fistula is 15.76%,it appears reduced tendency.With single-factor analysis,the factors effect on the rate of post-laryngectomy pharyngo-cutaneous fistula include clinical tumor stage,tumor types,preoperative radiotherapy,operation time,cleaning up cervical lymph node,whether with diabetes mellitus and malnutrition,nasal feeding time,and post-operative infection（P0.01）.Conclusion Early diagnosis and prompt treatment are crucial to prenvent this complication;pay more attention on the related factors about the pharyngo-cutaneous fistula,formulate rational treatment measures,may help prevent pharyngo-cutaneous fistula.