全喉切除术后咽瘘发生的相关因素分析

目的 分析全喉切除术后并发咽瘘的相关因素,探讨发生咽瘘的原因,并针对原因提出防治措施.方法 回顾性分析首次住院行全喉切除术的1 18例患者的完整临床资料.应用单因素分析性别、年龄、术前营养状况、术前放疗、术前气管切开、颈部淋巴结清扫术、肿瘤部位、临床分期、病理类型及感染等因素与咽瘘发生的关系.结果 1 18例全喉切除术患者中,17例发生咽瘘,发生率为14.4％（17/118）,通过统计学分析结果发现与咽瘘发生相关的因素有：患者术前营养状况、术前放疗、临床分期、感染.结论 全喉切除术后并发咽瘘是最常见并发症之一,发生咽瘘的原因有多重性,避免相关因素,能有效降低咽瘘的发生率,提高患者术后生存质量.

Analysis of the related factors to pharyngocutaneous fistula after total laryngectomy

Objective To analyze the related factors,and discuss the causes and prevention measures of pharyngocutaneous fistula caused by total laryngectomy.Methods The complete chnical data of 118 patients underwent laryngeal ancer surgery were analyzed retrospectively.Analyzed the relationship between pharyngocutaneous fistula and the factors of sex,age,pre-operative nutrition states,preoperative radiotherapy,prior tracheotomy,neck dissection,tumor position,clinical stage of tumor,patho-staging,post-operative infection comobidity with analysis of single factor.Results Among the 118 cases of laryngeal carcinoma,17 cases were pharyngocutaneous fistula after operation,the incidence was 14.4% （17/118）.According to the statistical analysis results,the predominant influencing factors in the causation of pharyngocutaneous fistula were：pre-operative nutrition states,pre-operative radiotherapy,clinical stage of tumor and post-operative infection.Concusion Pharyngocutaneous fistula after total laryngectomy is related to many factors,avoiding the above mentioned factors can reduce the rate of fistula and improve the life quality.