宫颈癌放疗患者并发会阴部放射性皮炎的影响因素分析

Analysis of influencing factors of perineal radio-dermatitis in patients undergoing cervical cancer radiotherapy

目的探讨宫颈癌放疗患者并发会阴部放射性皮炎(RD)的相关因素及其防控护理对策。方法选取2019年1月—2020年1月116例接受宫颈癌放疗患者的临床资料,跟踪观察90 d,评估其会阴部皮肤状况。收集其相关资料,采用单因素分析和多因素Logistic回归分析,筛选宫颈癌放疗并发会阴部RD的影响因素。结果116例接受宫颈癌放疗患者中,随访有33例(28.45%)患者并发会阴部RD,其中,放疗时23例,放疗结束后10例。单因素分析显示,放疗方式、FIGO分期、年龄、肿瘤直径、体质量指数、糖尿病史、肿瘤浸润深度为宫颈癌放疗并发会阴部RD的相关因素(P<0.05)。多因素分析显示,体质量指数>28、FIGO分期为Ⅱa期、常规放疗方式、有糖尿病史为放射性皮炎发生的影响因素(P<0.05)。结论宫颈癌放疗患者并发会阴部RD是多因素相互作用结果,调强放射治疗(IMRT)会阴部RD发生率明显低于常规放疗放射,严格掌握补偿膜使用指征,积极处理肥胖、有糖尿病病史患者的会阴部清洁,可降低会阴部RD发生风险。

Objective To explore the related factors of perineal radio-dermatitis(RD)in patients undergoing cervical cancer radiotherapy and their prevention and control measures.Methods The clinical data of 116 patients receiving cervical cancer radiotherapy from January 2019 to January 2020 were selected and we followed up for 90 days to assess their perineal skin conditions.The relevant data were collected,and univariate analysis and multivariate Logistic regression analysis were used to screen the influencing factors of cervical cancer radiotherapy with perineal RD.Results Among 116 patients who received radiotherapy for cervical cancer,33 patients(28.45%)were followed up with perineal radio-dermatitis,of which 23 cases were during radiotherapy and 10 cases were after radiotherapy.Univariate analysis showed that the radiotherapy methods,FIGO staging,age,tumor diameter,body mass index,history of diabetes,and depth of tumor invasion were the related factors for cervical cancer radiotherapy with perineal RD(P<0.05).Multivariate analysis showed that the body mass index>28,FIGO staging wasⅡa,conventional radiotherapy,and history of diabetes were the influencing factors of radio-dermatitis(P<0.05).Conclusion The concurrency of perineal RD in cervical cancer radiotherapy patients was the result of multi-factor interaction.The incidence of intensity modulated radiotherapy(IMRT)perineal RD was significantly lower than that of conventional radiotherapy.Strictly grasp the indications for the use of compensation film,and actively deal with the perineal cleansing of obese patients with a history of diabetes,which can reduce the risk of perineal RD.