喉癌术后咽瘘发生的相关因素分析

Analysis of factors related to pharyngo-cutaneous fistula after surgical treatment of laryngeal carcinoma

目的探讨喉癌切除术后咽瘘发生的相关因素。方法回顾性总结2012年1月-2012年12月首次住院的124例喉癌手术患者的临床资料,应用SASS 9.2软件对影响咽瘘的因素进行统计学分析。结果 124例喉癌患者中12例（9.7%）发生术后咽瘘,所有咽瘘患者均经保守治疗后瘘口愈合。结论单因素分析表明慢性病、术前营养状况、术前气管切开、术前放疗、肿瘤分型、临床分期、手术时间、手术方式、同期颈廓清术及术后感染等因素与咽瘘发生有关;多因素分析表明同期颈廓清术、肿瘤分型及慢性病与咽瘘发生有关。

Objective To discuss the predisposing factors related to pharyngo-cutaneous fistulas after surgical treatment of laryngeal carcinoma. Methods Clinical data of 124 patients with laryngeal carcinoma and undergoing laryngectomy from Jan 2012 to Dec 2012 in our department were analyzed retrospectively. Results Of all the 124 cases,postoperative pharyngo-cutaneous fistulas occurred in 12 with an incidence rate of 9.7%. The pharyngocutaneous fistulas in all the 9 cases got cured with conservative management. Conclusion Single-factor analysis shows that parameters related to the occurrence of post-laryngectomy pharyngo-cutaneous fistula include chronic diseases,preoperative nutrition state,preoperative tracheostomy,preoperative radiotherapy,clinical type and stage of tumor,surgical approach,operation time,simultaneous neck dissection and postoperative infection. Multi-factor analysis indicates that pharyngo-cutaneous fistula is associated with simultaneous neck dissection,the clinical type of tumor and chronic disease.