喉癌下咽癌术后咽瘘发生的危险因素分析

摘要

Objective To investigate the risk factors of pharyngo‐cutaneous fistula after surgery for larynx and hyperpharynx cancer .Methods 188 cases of larynx and hyperpharynx cancer from 2002 to 2012 at otorlaryngology department were collected into the research ,and the 12 kinds of risk factors of pharyngo‐cutaneous fistula after sur‐gery for larynx and hyperpharynx cancer were analized with univariate and multivariate Logistic regression analysis . Results In all these 188 cases of larynx and hyperpharynx cancer ,40 cases had pharyngo‐cutaneous fistula after op‐eration(21 .2% ) ,among 169 laryngeal carcinomas ,32 cases (18 .9% ) had pharyngo‐cutaneous fistula and 8/19 (42 .1% )of hyperpharynx carcinoma .The tumor stage ,operation method ,preopertion radiation ,diebete ,flap grafting , tumor site were the relative risk factors ,but Logistic regression analysis indicated the tumor stage ,preopertion radia‐tion ,flap grafting were the independent risk factors .Conclusion The tumor stage ,preopertion radiation ,flap grafting were significantly relative with pharyngo‐cutaneous fistula after surgery for larynx and hyperpharynx cancer .%目的：探讨喉癌下咽癌术后咽瘘发生的危险因素。方法该院2002～2012年接受喉癌下咽癌手术的188例患者，对影响喉癌下咽癌术后咽瘘发生的12种危险因素进行单因素和多因素Logistic回归分析。结果188例患者喉癌下咽癌术后发生咽瘘40例，发生率21．2％，其中喉癌169例，发生咽瘘32例，发生率18．9％，下咽癌19例，发生咽瘘8例，发生率42．1％。单因素分析表明肿瘤分期、手术方式、术前放疗、糖尿病、行皮瓣修复、肿瘤部位是咽瘘发生的相关因素，而多因素Logistic回归分析显示，手术方式、术前放疗、行皮瓣修复是术后咽瘘发生的独立危险因素。结论肿瘤分期、术前放疗、行皮瓣修复与喉癌下咽癌术后咽瘘发生密切相关。