喉癌全切手术后患者气管感染对肺功能及肿瘤复发的影响

发布时间：2018-02-16 16:30

  本文关键词： 喉癌全切术 气管感染 肺功能 肿瘤复发　出处：《中国老年学杂志》2014年17期 　论文类型：期刊论文

【摘要】：目的研究喉癌全切手术后患者气管感染对肺功能及肿瘤复发的影响。方法从2012年7月至2013年7月选择在该院实施喉癌全切术的患者94例,51例行喉癌全切术,43例行喉癌全切术联合颈部淋巴结清扫术,观察术后气管感染情况并分析气管感染对患者肺功能及肿瘤复发的影响。结果实施喉癌全切术的患者感染率为5.88%(3/51),显著低于实施喉癌全切术联合颈部淋巴结清扫术的25.58%(11/43);手术时间4 h的患者感染率为2.08%(1/48),显著低于手术时间为4~6 h的15.63%(5/32)及6 h的57.14%(8/14),且手术时间为4~6 h的感染率亦显著低于6 h者(均P0.05)。根据Spearman法分析手术时间与气管感染的相关性后发现,时间越长,感染率越高,二者呈正相关联系(r=0.884,P=0.001)。手术后发生气管感染的14例患者1 s用力呼气的容积(FEV)1%为67.11±4.03,显著高于手术前的59.59±2.85;25%肺活量的最大呼气流量(V25)为(0.71±0.42)L/s,显著低于手术前的(1.03±0.22)L/s(均P0.05)。手术后用力肺活量(FVC)水平下降,FEV1、最大呼气的中段流量(MMEF)及V50水平均有所上升,但均无差异(均P0.05)。发生气管感染的一组复发率为7.14%(1/14),与未感染组的10.00%(8/80)相比无差异(P0.05)。结论喉癌全切手术后易导致感染和肺功能变化,患者有一定比例的肿瘤复发症状,应采取措施尽可能地规避,值得临床关注。
[Abstract]:Objective to study the effect of trachea infection on lung function and tumor recurrence in patients with laryngeal cancer after total laryngeal cancer resection. Methods from July 2012 to July 2013, 94 patients with laryngeal cancer underwent total laryngeal cancer resection and 43 patients underwent total laryngeal cancer resection. Total laryngectomy combined with neck lymph node dissection, The effect of trachea infection on lung function and tumor recurrence was analyzed. Results the infection rate of patients undergoing total laryngeal cancer resection was 5.88 / 51, which was significantly lower than that of total laryngectomy combined with neck lymph node dissection. The infection rate of the patients with 4 hours operation time was 2.08 / 48, significantly lower than that of 15.6365 / 32 and 57.14 / 14 / 14 in 4h and 6h, and the infection rate of 4h / 6h was significantly lower than that of 6h patients (all P 0.05). According to the Spearman method, the operative time and trachea were analyzed. The correlation between infection and infection was found, The longer the infection rate, the higher the infection rate. There was a positive correlation between the two factors. The FEV1% of forced expiratory volume in 14 patients with trachea infection after operation was 67.11 卤4.03, which was significantly higher than that of 59.59 卤2.8525% vital capacity V25 (0.71 卤0.42L / s), which was significantly lower than that before operation (1.03 卤0.22L / s) (all P 0.05). The level of forced vital capacity (FVC) decreased and FEV1, MMEF1 and V50 increased. But there was no difference (P 0.05). The recurrence rate of the group with trachea infection was 7.14 / 14, which was similar to that of the non-infected group (10.00 / 8 / 80). Conclusion the laryngeal carcinoma is prone to infection and pulmonary function changes after total laryngotomy, and the patients have a certain proportion of recurrence symptoms. Measures should be taken to avoid it as far as possible, and it deserves clinical attention.
【作者单位】： 潍坊市寒亭区人民医院耳鼻咽喉头颈外科;
【分类号】：R739.65
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本文编号：1515947