鼻咽癌放疗并发分泌性中耳炎的临床病理特征及影响因素分析

Analysis on the Clinicopathological Characteristics and Influencing Factors of Nasopharyngeal Carcinoma Radiotherapy Complicated with Secretory Otitis Media

目的探讨鼻咽癌放疗并发分泌性中耳炎(SOM)的临床病理特征及影响因素。方法回顾性分析我院2017年1月至2018年6月行放疗的60例鼻咽癌患者的临床资料,其中32例鼻咽癌放疗并发SOM患者作为病例组,28例鼻咽癌放疗未并发SOM患者作为对照组。分析患者的临床病理特征,并采用Logistic回归分析影响鼻咽癌放疗患者并发SOM的相关因素。结果不同时间段鼻咽癌放疗后并发SOM发生率比较有统计学差异(P <0.05)。鼻咽癌放疗并发SOM与放疗剂量、放疗时间、咽鼓管受累、肿瘤分期及腭帆张肌萎缩程度有相关性(P <0.05);Logistic多因素回归分析显示,放疗剂量、肿瘤分期、腭帆张肌萎缩程度、咽鼓管侵犯为影响鼻咽癌放疗并发SOM的独立危险因素(P <0.05)。结论鼻咽癌放疗并发SOM多见于单侧,且放疗后3个月发生率最高,其中放疗剂量、肿瘤分期、腭帆张肌萎缩程度、咽鼓管侵犯可能是导致鼻咽癌并发SOM的独立危险因素。

Objective To analyze the clinicopathological characteristics and influencing factors of nasopharyngeal carcinoma(NPC)radiotherapy complicated with secretory otitis media(SOM).Methods The clinical data of 60 patients undergoing radiotherapy for NPC in our hospital from January 2017 to June 2018 were retrospectively analyzed.32 NPC patients with SOM after radiotherapy were selected as case group,while 28 NPC patients without SOM after radiotherapy were selected as control group.The clinicopathological characteristics of patients were analyzed,and the related factors affecting the patients with NPC radiotherapy complicated with SOM were analyzed by Logistic regression analysis.Results Statistical difference was found in the incidence of SOM after NPC radiotherapy at different time period(P<0.05).NPC radiotherapy complicated with SOM after radiotherapy was significantly related to radiotherapy dose,radiotherapy time,eustachian tube involvement,tumor stage and atrophy degree of tensor veli palatini muscle(P<0.05).Logistic regression analysis showed that radiotherapy dose,tumor stage,atrophy degree of tensor veli palatini muscle and eustachian tube involvement were independent risk factors for NPC radiotherapy complicated with SOM(P<0.05).Conclusions NPC radiotherapy complicated with SOM is mostly unilateral,and the incidence is the highest in 3 months after radiotherapy.Radiotherapy dose,tumor stage,atrophy degree of tensor veli palatini muscle and eustachian tube involvement may be independent risk factors for NPC complicated with SOM.