摘要
目的探讨鼻咽癌(NPC)放疗致鼻窦炎发生的临床特征、影响因素。方法回顾性分析2014年1月—2017年6月期间,我院收治的228例NPC患者临床资料,根据患者是否进行放疗,将患者分为非放疗组(106例)和放疗组(122例)。对比分析两组鼻咽癌致鼻窦炎的临床特点,以单因素和多因素Logistic分析鼻咽癌患者放疗后发生鼻窦炎的影响因素。结果放疗组患者鼻窦炎发生率为81. 97%,高于非放疗组患者鼻窦炎发生率54. 72%,差异有统计学意义(P <0. 05)。放疗组鼻窦炎累及部位发生率从高到低,依次为后组筛窦、蝶窦、前组筛窦、窦口鼻道复合体、额窦以及上颌窦。放疗组患者鼻窦炎后组筛窦、蝶窦累及率高于非放疗组患者,差异具有统计学意义(P <0. 05)。单因素分析结果显示,放疗后鼻窦炎的发生,与患者年龄是否> 50岁,病程是否> 2年,是否存在鼻腔侵犯,肿瘤分期,是否使用滴鼻剂及是否进行鼻咽冲洗有关,差异有统计学意义(P <0. 05)。多因素Logistic回归分析结果显示,患者病程> 2年,存在鼻腔侵犯以及T3+T4期肿瘤是NPC放疗后鼻窦炎发生的独立危险因素;使用滴鼻剂和鼻咽冲洗是NPC放疗后鼻窦炎发生的保护因素。结论 NPC放疗后具有较高的鼻窦炎发生率,并且主要累及后组筛窦和蝶窦,对于病程> 2年、存在鼻腔侵犯以及T3+T4期肿瘤的患者,应积极采取措施预防鼻窦炎的发生,使用滴鼻剂和鼻咽冲洗是预防NPC放疗后鼻窦炎发生的有效措施。
Objective To investigate the clinical features and influeneing factors of nasosinusitis caused by naso- pharyngeal carcinoma （NPC） radiotherapy. Methods The clinical data of 228 NPC patients admitted to our hospital from January 2014 to June 2017 were retrospectively analyzed. According to whether the patients were treated with radiotherapy, the patients were divided into non-radiotherapy group （ 106 eases） and radiotherapy group （ 122 eases）. The clinical characteristics of nasosinusitis were analyzed and compared. Univariate and multivariate logistic analysis was used to analyze the influencing factors of nasosinusitis after radiotherapy in patients with nasophary-ngeal carcinoma. Results The incidence of sinusitis was 81.97% in the radiotherapy group, which was higher than that in the non-radiotherapy group （54. 72% ）. The difference was statistical significance （ P 〈 0. 05 ）. The incidence of sinusitis involvement in the radiotherapy group was in the order of ethmoid sinus, sphenoid sinus, anterior ethmoid sinus, sinus osfium and nasal tract sinus complex, frontal sinus, and maxillary sinus. The incidences of ethmoid sinus and sphenoid sinus in the post-nasal sinusitis group were higher than that in the non-radiotherapy group （ P 〈 0. 05 ）. Univariate analysis showed that the occurrence of sinusitis after radiotherapy was related to whether the patient＇s age was 〉 50 years, whether the disease duration was 〉 2 years, whether there was nasal invasion, tumor staging, whether nasal drops were used, and whether nasophary-ngeal irrigation was performed. Multivariate logistic regression analysis showed that patients with a disease course of 〉 2 years had nasal invasion and T3 ＋ T4 tumors were independent risk factors for sinusitis after NPC radiotherapy; use of nasal drops and nasophary-ngeal washing were protective factors. Conclusion There is a higher incidence of sinusitis after radiotherapy of NPC, and mainly affects the ethmoid sinus and sphenoid sinus in the posterior group. Patients with a disease course of 〉 2 years, with nasal invasion, and T3 ＋ T4 tumors should actively take measures to prevent the occurrence of sinusitis. The use of nose drops and nasophary-ngeal washing is an effective measure to prevent the occurrence of sinusitis after NPC radiotherapy.
作者
黎婉红
蔡邦
莫鉴文
胡永成
王振英
陈国锋
LI Wanhong;CAI Bang;MO Jianwen;HU Yongcheng;WANG Zhenying;CHEN Guofeng(Department of Otorhinolaryngology,Yunfu People＇s Hospital,Yunfu 527300,China;Cancer prevention and control center of Yunfu,Yunfu 527300,China)
出处
《广州医药》
2018年第5期24-28,共5页
Guangzhou Medical Journal
基金
云浮市科学卫生局(2015B23)
关键词
鼻咽癌
放疗
鼻窦炎
危险因素
Nasophary-ngeal carcinoma
Radiotherapy
Sinusitis
Risk factors
