食道钡剂造影对鼻咽癌患者放疗后的吞咽功能评估

Esophageal Barium Contrast Agent in Patients with Nasopharyngeal Carcinoma after Radiotherapy with Evaluation of Swallowing Function

目的研究食道钡剂造影对鼻咽癌患者放疗后吞咽功能的评估价值,为临床诊治提供参考。方法对2012年1月-2015年12月间收治的鼻咽癌放疗后的患者156例进行回顾性分析,其中78例进行过调强放疗治疗(设为观察组),78例进行过常规放疗治疗(设为对照组)。两组患者均进行食道钡剂造影检查及随访调查,并与其喉镜检查结果比较,对比三者结果并作深入分析。结果应用食道钡剂造影检查发现观察组出现吞咽障碍总计为55.13%(43/78),显著低于对照组的85.90%(67/78);通过随访调查统计得到观察组出现吞咽功能障碍患者总计60.26%(47/78),显著低于对照组的91.03%(71/78);对喉镜检查结果对比发现观察组出现吞咽功能障碍总计56.41%(44/78),显著低于对照组的88.46%(69/78)。最后对比三种结果得到两组中食道钡剂造影与随访调查、喉镜对鼻咽癌放疗后吞咽功能检查结果对比均差异无统计学意义(P>0.05)。结论鼻咽癌患者进行放疗治疗后普遍出现吞咽功能障碍,而调强放疗后出现的比例较低。采用食道钡剂造影检查后对吞咽功能障碍了解详细,可为了解病情发展严重程度及治疗提供依据,具有较高的应用价值。

Objective To explore the value of barium meal in the assessment of swallowing function after radiothera- py for nasopharyngeal carcinoma patients. Methods From Jan 2012 to Dec 2015, 156 patients with nasopharyngeal carcinoma who received radiotherapy in our hospital were retrospectively analyzed, and 78 cases were treated with intensity modulated ra- diotherapy （denoted as the observation group） and 78 cases were treated with conventional radiotherapy （control group）. The two groups of patients were examined by barium meal examination, questionnaire and electronic examination. The results were compared with those of three patients. Results A total of 55.13% （43/78） of dysphagia in the observation group was ob- served with the barium enema examination, and 85.90% （67/78） was significantly lower than that in the control group. A total of 60. 26% （47/78） in the observation group were observed with the questionnaire survey, and the total of the patients with dysphagia was significantly lower than that of the control group 91.03% （71/78）. And the results showed that the observation group was significantly lower than the control group 56. 41% （44/78）, which was significantly lower than the control group 88. 46% （69/78）. In the end of the two groups, there had no signifance in the results of three tests （P 〉0. 05）. Conclusion The patients with nasopharyngeal carcinoma after radiotherapy treatment generally have dysphagia, the proportion of swallo- wing dysfunction after the intensity modulated radiation therapy is lower. And the use of esophageal barium meal examination after the examination of swallowing dysfunction in detail can be in clinical practice to understand the severity of disease devel- opment, treatment to provide guidance. Safety is high, and the clinical Hassan has a very high application value.