喉癌术后发生咽瘘的相关因素分析

Related factors analysis of pharyngeal fistula complications of postoperative laryngeal

目的分析喉癌术后发生咽瘘的相关因素。方法选取2011年5月至2014年5月接受喉癌切除手术的84例患者作为研究对象,观察术后发生咽瘘患者的临床症状,详细记录患者的年龄、性别、喉癌分期、吸烟史、饮酒史、有糖尿病史、手术时间、手术方式、术中气管切开情况、术中引流方式、术后营养情况、术后感染和口腔清洗方式,分析其与咽瘘的关系。结果患者性别、年龄、有无吸烟史和饮酒史与咽瘘的发生无关,差异均无统计学意义(P>0.05);而肿瘤分期、糖尿病史与咽瘘的发生有关,差异均有统计学意义(P<0.05)。手术时间、术中是否切开气管、引流方式与咽瘘的发生有关,差异有统计学意义(P<0.05);而手术方式与咽瘘的发生无关,差异无统计学意义(P>0.05)。患者喉切术后营养水平、感染情况及口腔护理方法均可影响咽瘘的发生,差异均有统计学意(P<0.05)。结论影响喉切除术后咽瘘发生的因素较多,主要与糖尿病史、肿瘤分期、手术时间、术中引流方式、术中气管切开情况、术后营养状况、感染及口腔护理方法等有关。

Objective To analyze the related factors analysis of pharyngeal fistula complications of postoperative laryngeal. Methods Eighty-four cases of laryngeal surgery patients from Central Hospital of Panjin City May 2011 to May 2014 were treated as an object of study of this experiment,laryngeal cancer and after surgery were successful removal of part or all of the throat of laryngeal cancer patients,observed laryngectomy pharyngeal fistula complication after all clinical symptoms occur,a detailed record of the part of the patient＇s age,sex,laryngeal tumor stage,whether there is a history of smoking,drinking history,whether with diabetes,surgery time,whether or total removal of the larynx,trachea whether incision surgery,intraoperative whether to use plasma tube drainage method,whether postoperative nutrition comprehensive,with or without the occurrence of postoperative infection,oral cleaning methods,analysis and comparison of the above factors and pharyngeal fistula complications relations. Results Gender,age,with or without previous history of smoking and drinking history had no relationship to pharyngeal fistula,with no statistical significance（ P〉0. 05）; tumor stage and suffering from diabetes showed relationship to to pharyngeal fistula,with statistical significance（ P〈0. 05）. The operative time,intraoperative whether tracheotomy,whether to adopt the plasma tube drainage ways showed relationship to the occurrence of pharyngeal fistula disease,with statistical significance（ P〈0. 05）; Partial or total removal of the larynx had no relationship to the occurrence of pharyngeal fistula disease,with no statistical significance（ P〉0. 05）. Laryngectomy patients nutritional level,with or without postoperative infection and oral care can affect pharyngeal fistula complications,with statistical significance（ P〈0. 05）. Conclusions Many factors can affect laryngectomy pharyngeal fistula occurrence： diabetes,tumor stage,surgery time,intraoperative drainage way,whether tracheal surgery,postoperative nutrition situation,with or without infection and oral care methods and so on.