头颈部肿瘤放射治疗并发鼻窦炎的临床分析

Clinical analysis of nasosinusitis with tumor radiotherapy in the head and neck

目的分析头颈部肿瘤放射治疗并发鼻窦炎临床特征、疗效,总结防治经验。方法选择2016年1月~2017年5月医院收治的20例头颈部肿瘤放射治疗并发鼻窦炎患者作为研究对象,所有对象都采用滴鼻剂、生活管理等方法预防鼻窦炎,参照《慢性鼻-鼻窦炎诊断和治疗指南》诊断,诊断后采用配置溶液进行鼻腔与鼻咽部冲洗。结果诊断时、放疗结束时、放疗后1周TNSS、TNNSS评分呈持续下降趋势,差异有统计学意义(P<0.05),放疗后1周,鼻塞等症状基本消失,部分对象仍然遗留鼻痒、偶发喷嚏等症状,不影响生活。放疗后1周,内镜检查水肿发生率0.0%(0/20),低于诊断时100.0%(20/20),差异有统计学意义(P<0.05),患者鼻黏膜愈合较好,未见鼻漏、瘢痕形成等异常。结论头颈部肿瘤放射治疗并发鼻窦炎需要综合管理,诊断后积极治疗,绝大多数症状可控制。

Objective To analyze the clinical features and efficacy of nasosinusitis in the radiotherapy of head and neck tumors,and to summarize the experience of prevention and treatment.Methods From January 2016 to May 2017,20 cases were treated in the hospital for head and neck cancer radiotherapy with sinusitis,nasal drops by all objects,life management and other methods to prevent sinusitis,referring to the chronic rhinosinusitis guidelines for the diagnosis and treatment of diagnosis,diagnosis after using configuration solution for nasal cavity and nasopharynx flushing.Results At the time of diagnosis,at the end of radiotherapy,after radiotherapy 1 weeks TNSS and TNNSS scores had decreased,the difference was statistically significant(P<0.05),1 weeks after radiotherapy,stuffy nose and other symptoms disappeared,part of the object still left nasal itching,sneezing and other incidental symptoms,does not affect the life.After 1 weeks after radiotherapy,endoscopy edema occurred in 0%(0/20),100%(20/20)lower than at the time of diagnosis,the difference was statistically significant(P<0.05),mucosal healing is good,no leakage,abnormal scar formation.Conclusion Head and neck tumor radiotherapy combined with nasosinusitis needs comprehensive management,positive treatment after diagnosis,the vast majority of the symptoms can be controlled.