B超检测腮腺血流在评价鼻咽癌放疗患者口干程度中的应用

目的 探讨B超检测在IMRT过程中评价鼻咽癌患者口干程度的有效性。方法 收集2013—2014年间本院收治的鼻咽癌患者30例,根据RTOG“涎腺急性放疗损伤评估表”对患者自觉口干程度进行评分,采用彩色多普勒超声技术检测鼻咽癌患者IMRT前、中、后的腮腺小血管收缩期峰值血流速度、颌下腺血管收缩期峰值血流速度和腮腺血管内径变化情况,对各项指标与患者口干程度间相关性采用方差分析等。结果 28例鼻咽癌患者IMRT过程中患者口干程度较IMRT前明显加重(P=0.024),IMRT后3个月较IMRT中明显降低(P=0.035);IMRT中腮腺小血管收缩期峰值血流速度、颌下腺血管收缩期峰值血流速度和腮腺血管内径出现缩小比例较IMRT前明显升高(P=0.001、0.003;P=0.001);IMRT停止3个月后的上述指标较IMRT中均明显下降(P=0.008、0.012;P=0.001);IMRT中和IMRT后腮腺小血管收缩期峰值血流速度与患者口干程度相关性更大(r=0.563、0.409,P=0.026、0.031)。结论 腮腺血流B超检测可以无创检测腮腺血流动力学的变化,对于评价鼻咽癌患者IMRT中和IMRT后口干严重程度具有一定的临床参考价值。

Application of ultrasound in evaluating degree of xerostomia in patients with nasopharyngeal carcinoma receiving radiotherapy

Objective To investigate the effectiveness of ultrasound in evaluating the degree of xerostomia in the patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT). Methods A total of 30 NPC patients who were admitted to our hospital from May 2013 to December 2014 were enrolled in this study. The degree of xerostomia in these NPC patients was scored according to the Radiation Therapy Oncology Group scoring criteria. Color Doppler ultrasound was used to measure the peak systolic blood flow velocity of the parotid gland and submandibular gland and the changes in vascular diameter of the parotid gland in the NPC patients before, during, and after IMRT. The correlation between each parameter and the degree of xerostomia was determined by analysis of variance. Results In the 28 NPC patients included in the statistical analysis, the degree of xerostomia during IMRT was significantly higher than that before IMRT (P=0.024), and the degree of xerostomia at 3 months after IMRT was significantly lower than that during IMRT (P=0.035). The peak systolic blood flow velocity of the parotid gland and submandibular gland and the proportion of patients with decreases in vascular diameter of the parotid gland during IMRT were significantly higher than those before IMRT (P=0.001 and 0.003;P=0.001);the above parameters at 3 months after IMRT were significantly lower than those during IMRT (P=0.008 and 0.012;P=0.001). During IMRT and after IMRT, the degree of xerostomia was significantly correlated with the peak systolic blood flow velocity of the parotid gland (r=0.563, P=0.026;r=0.409, P=0.031). Conclusions Ultrasound can be used as a noninvasive detection for the hemodynamic changes in the parotid gland, and it has a certain clinical reference value for evaluating the degree of xerostomia in NPC patients during and after IMRT.